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Sample records for active middle ear

  1. [Bone Conduction and Active Middle Ear Implants].

    PubMed

    Volkenstein, S; Thomas, J P; Dazert, S

    2016-05-01

    The majority of patients with moderate to severe hearing loss can be supplied with conventional hearing aids depending on severity and cause for hearing loss in a satisfying way. However, some patients either do not benefit enough from conventional hearing aids or cannot wear them due to inflammatory reactions and chronic infections of the external auditory canal or due to anatomical reasons. For these patients there are fully- and semi-implantable middle ear and bone conduction implants available. These devices either directly stimulate the skull (bone conduction devices), middle ear structures (active middle ear implants) or the cochlea itself (direct acoustic stimulation). Patients who failed surgical hearing rehabilitation or do not benefit from conventional hearing aids may achieve a significant better speech understanding and tremendous improvement in quality of life by implantable hearing devices with careful attention to the audiological and anatomical indication criteria.

  2. Passive and active middle ear implants

    PubMed Central

    Beutner, Dirk; Hüttenbrink, Karl-Bernd

    2011-01-01

    Besides eradication of chronic middle ear disease, the reconstruction of the sound conduction apparatus is a major goal of modern ear microsurgery. The material of choice in cases of partial ossicular replacement prosthesis is the autogenous ossicle. In the event of more extensive destruction of the ossicular chain diverse alloplastic materials, e.g. metals, ceramics, plastics or composits are used for total reconstruction. Their specialised role in conducting sound energy within a half-open implant bed sets high demands on the biocompatibility as well as the acoustic-mechanic properties of the prosthesis. Recently, sophisticated titanium middle ear implants allowing individual adaptation to anatomical variations are widely used for this procedure. However, despite modern developments, hearing restoration with passive implants often faces its limitations due to tubal-middle-ear dysfunction. Here, implantable hearing aids, successfully used in cases of sensorineural hearing loss, offer a promising alternative. This article reviews the actual state of affairs of passive and active middle ear implants. PMID:22073102

  3. Historical development of active middle ear implants.

    PubMed

    Carlson, Matthew L; Pelosi, Stanley; Haynes, David S

    2014-12-01

    Active middle ear implants (AMEIs) are sophisticated technologies designed to overcome many of the shortcomings of conventional hearing aids, including feedback, distortion, and occlusion effect. Three AMEIs are currently approved by the US Food and Drug Administration for implantation in patients with sensorineural hearing loss. In this article, the history of AMEI technologies is reviewed, individual component development is outlined, past and current implant systems are described, and design and implementation successes and dead ends are highlighted. Past and ongoing challenges facing AMEI development are reviewed.

  4. Middle ear infection (image)

    MedlinePlus

    A middle ear infection is also known as otitis media. It is one of the most common of childhood infections. With this illness, the middle ear becomes red, swollen, and inflamed because of bacteria ...

  5. The role of radiology in active middle ear implantation.

    PubMed

    Loney, E L

    2014-08-01

    Active middle ear implants (AMEIs) have been available for a number of years and yet most radiologists have never heard of them. Some bear a striking resemblance to cochlear implants whereas others are more similar to conventional hearing aids. The aims of this review are to provide an introduction as to the types of implants available, how they work and when they are indicated. Also, to highlight important pre-operative imaging features that can influence surgery and to consider the role of imaging in the post-operative setting. As patient choice increases, it becomes more likely that radiologists will encounter these devices in daily practice and knowledge of them may prove useful.

  6. Wideband detection of middle ear muscle activation using swept-tone distortion product otoacoustic emissions.

    PubMed

    Henin, Simon; Long, Glenis R; Thompson, Suzanne

    2014-07-01

    The measurement of efferent-induced suppression of otoacoustic emissions (OAEs) using contralateral acoustic stimulation (CAS) is complicated by potential contamination by the middle ear muscle reflex (MEMR), particularly at moderate to high CAS levels. When logarithmically sweeping primaries are used to measure distortion product otoacoustic emissions, the level and phase of the primaries at the entrance of the ear canal may be monitored simultaneously along with the OAEs elicited by the swept-tones. A method of detecting MEMR activation using swept-tones is presented in which the differences in the primaries in the ear canal with and without CAS are examined, permitting evaluation of MEMR effects over a broad frequency range. A range of CAS levels above and below expected contralateral acoustic reflex thresholds permitted evaluation of conditions with and without MEMR activation.

  7. Middle Ear Infections and Ear Tube Surgery (For Parents)

    MedlinePlus

    ... Zika & Pregnancy Middle Ear Infections and Ear Tube Surgery KidsHealth > For Parents > Middle Ear Infections and Ear ... medio y colocación de tubos de ventilación Why Surgery? Many kids get middle ear infections (known as ...

  8. Middle Ear Infections (For Parents)

    MedlinePlus

    ... in the first 2 to 4 years of life for several reasons: Their eustachian tubes are shorter and more horizontal than those of adults, which lets bacteria and viruses find their way into the middle ear more ...

  9. Middle ear infection (otitis media) (image)

    MedlinePlus

    ... is an inflammation and/or infection of the middle ear. Acute otitis media (acute ear infection) occurs ... or viral infection of the fluid of the middle ear, which causes production of fluid or pus. ...

  10. Role of p38 Mitogen-Activated Protein Kinase in Middle Ear Mucosa Hyperplasia during Bacterial Otitis Media

    PubMed Central

    Palacios, Sean D.; Pak, Kwang; Rivkin, Alexander Z.; Kayali, Ayse G.; Austen, Darrell; Aletsee, Christoph; Melhus, Åsa; Webster, Nicholas J. G.; Ryan, Allen F.

    2004-01-01

    Hyperplasia of the middle ear mucosa contributes to the sequelae of acute otitis media. Understanding the signal transduction pathways that mediate hyperplasia could lead to the development of new therapeutic interventions for this disease and its sequelae. Endotoxin derived from bacteria involved in middle ear infection can contribute to the hyperplastic response. The p38 mitogen-activated protein kinase (MAPK) is known to be activated by endotoxin as well as cytokines and other inflammatory mediators that have been documented in otitis media. We assessed the activation of p38 in the middle ear mucosa of an in vivo rat bacterial otitis media model. Strong activity of p38 was observed 1 to 6 h after bacterial inoculation. Activity continued at a lower level for at least 7 days. The effects of p38 activation were assessed using an in vitro model of rat middle ear mucosal hyperplasia in which mucosal growth is stimulated by nontypeable Haemophilus influenzae during acute otitis media. Hyperplastic mucosal explants treated with the p38α and p38β inhibitor SB203580 demonstrated significant inhibition of otitis media-stimulated mucosal growth. The results of this study suggest that intracellular signaling via p38 MAPK influences the hyperplastic response of the middle ear mucosa during bacterial otitis media. PMID:15271927

  11. Pseudomonas aeruginosa Activates PKC-Alpha to Invade Middle Ear Epithelial Cells

    PubMed Central

    Mittal, Rahul; Grati, M’hamed; Yan, Denise; Liu, Xue Z.

    2016-01-01

    Otitis media (OM) is a group of complex inflammatory disorders affecting the middle ear which can be acute or chronic. Chronic suppurative otitis media (CSOM) is a form of chronic OM characterized by tympanic membrane perforation and discharge. Despite the significant impact of CSOM on human population, it is still an understudied and unexplored research area. CSOM is a leading cause of hearing loss and life-threatening central nervous system complications. Bacterial exposure especially Pseudomonas aeruginosa is the most common cause of CSOM. Our previous studies have demonstrated that P. aeruginosa invades human middle ear epithelial cells (HMEECs). However, molecular mechanisms leading to bacterial invasion of HMEECs are not known. The aim of this study is to characterize the role of PKC pathway in the ability of P. aeruginosa to colonize HMEECs. We observed that otopathogenic P. aeruginosa activates the PKC pathway, specifically phosphorylation of PKC-alpha (PKC-α) in HMEECs. The ability of otopathogenic P. aeruginosa to phosphorylate PKC-α depends on bacterial OprF expression. The activation of PKC-α was associated with actin condensation. Blocking the PKC pathway attenuated the ability of bacteria to invade HMEECs and subsequent actin condensation. This study, for the first time, demonstrates that the host PKC-α pathway is involved in invasion of HMEECs by P. aeruginosa and subsequently to cause OM. Characterizing the role of the host signaling pathway in the pathogenesis of CSOM will provide novel avenues to design effective treatment modalities against the disease. PMID:26973629

  12. The influence of muscles activation on the dynamical behaviour of the tympano-ossicular system of the middle ear.

    PubMed

    Gentil, Fernanda; Parente, Marco; Martins, Pedro; Garbe, Carolina; Paço, João; Ferreira, António J M; Tavares, João Manuel R S; Jorge, Renato Natal

    2013-04-01

    The human ear is a complex biomechanical system and is divided into three parts: outer, middle and inner ear. The middle ear is formed by ossicles (malleus, incus and stapes), ligaments, muscles and tendons, which transfers sound vibrations from the eardrum to the inner ear, linking with mastoid and Eustachian tube. In this work, a finite element modelling of the tympano-ossicular system of the middle ear was developed. A dynamic study based on a structural response to harmonic vibrations, for a sound pressure level (SPL) of 110, 120 and 130 dB SPL applied in the eardrum, is presented. The connection between the ossicles is made using a contact formulation. The model includes the different ligaments considering its hyperelastic behaviour. The activation of the muscles is based on the constitutive model proposed by previous work. The harmonic responses of displacement and pressure obtained on the stapes footplate, for a frequency range between 100 Hz and 10 kHz, are obtained simulating the muscle activation. The results are compared considering the passive and active states. The results are discussed and they are in accordance with audiological data published with reference to the effects of the middle ear muscles contraction.

  13. Multiple Osteomas in Middle Ear

    PubMed Central

    Li, Yongxin; Li, Qiuhuan; Gong, Shusheng; Liu, Honggang; Yu, Zilong; Zhang, Luo

    2012-01-01

    Since the first description of middle ear osteomas by Thomas in 1964, only few reports were published within the English literatures (Greinwalid et al., 1998; Shimizu et al., 2003; Cho et al., 2005; and Jang et al., 2009), and only one case of the multiple osteomas in middle ear was described by Kim et al., 2006, which arose from the promontory, lateral semicircular canal, and epitympanum. Here we describe a patient with multiple middle ear osteomas arising from the promontory, incus, Eustachian tube, and bony semicanal of tensor tympani muscle. This patient also contracted the chronic otitis media in the ipsilateral ear. The osteomas were successfully removed by performing type III tympanoplasty in one stage. PMID:22928138

  14. Middle Ear Infections

    MedlinePlus

    ... Health Issues Conditions Abdominal ADHD Allergies & Asthma Autism Cancer Chest & Lungs Chronic Conditions Cleft & Craniofacial Developmental Disabilities Ear Nose & Throat Emotional Problems Eyes Fever From Insects or Animals Genitals and Urinary Tract Glands & Growth ...

  15. Activity of Faropenem against Middle Ear Fluid Pathogens from Children with Acute Otitis Media in Costa Rica and Israel▿

    PubMed Central

    Stone, Kimberley Clawson; Dagan, Ron; Arguedas, Adriano; Leibovitz, Eugene; Wang, Elaine; Echols, Roger M.; Janjic, Nebojsa; Critchley, Ian A.

    2007-01-01

    Faropenem was tested against 1,188 middle ear fluid pathogens from children in Israel and Costa Rica. Against Streptococcus pneumoniae and Haemophilus influenzae, faropenem was the most active β-lactam, with activity that was similar to or greater than of the other oral antimicrobial classes studied. Faropenem was also active against Moraxella catarrhalis and Streptococcus pyogenes. PMID:17387157

  16. Activity of faropenem against middle ear fluid pathogens from children with acute otitis media in Costa Rica and Israel.

    PubMed

    Stone, Kimberley Clawson; Dagan, Ron; Arguedas, Adriano; Leibovitz, Eugene; Wang, Elaine; Echols, Roger M; Janjic, Nebojsa; Critchley, Ian A

    2007-06-01

    Faropenem was tested against 1,188 middle ear fluid pathogens from children in Israel and Costa Rica. Against Streptococcus pneumoniae and Haemophilus influenzae, faropenem was the most active beta-lactam, with activity that was similar to or greater than of the other oral antimicrobial classes studied. Faropenem was also active against Moraxella catarrhalis and Streptococcus pyogenes. PMID:17387157

  17. Adenomatous tumors of the middle ear.

    PubMed

    Pelosi, Stanley; Koss, Shira

    2015-04-01

    Adenomatous tumors are an uncommon cause of a middle ear mass. Clinical findings may be nonspecific, leading to difficulties in differentiation from other middle ear tumors. Controversy also exists whether to classify middle ear adenoma and carcinoid as separate neoplasms, or alternatively within a spectrum of the same pathologic entity. Most adenomatous middle ear tumors are indolent in behavior, with a benign histologic appearance and slowly progressive growth. The mainstay of treatment is complete surgical resection, which affords the greatest likelihood of cure.

  18. Discovery of a Biological Mechanism of Active Transport through the Tympanic Membrane to the Middle Ear

    PubMed Central

    Kurabi, Arwa; Pak, Kwang K.; Bernhardt, Marlen; Baird, Andrew; Ryan, Allen F.

    2016-01-01

    Otitis media (OM) is a common pediatric disease for which systemic antibiotics are often prescribed. While local treatment would avoid the systemic treatment side-effects, the tympanic membrane (TM) represents an impenetrable barrier unless surgically breached. We hypothesized that the TM might harbor innate biological mechanisms that could mediate trans-TM transport. We used two M13-bacteriophage display biopanning strategies to search for mediators of trans-TM transport. First, aliquots of linear phage library displaying 1010th 12mer peptides were applied on the TM of rats with active bacterial OM. The middle ear (ME) contents were then harvested, amplified and the preparation re-applied for additional rounds. Second, the same naïve library was sequentially screened for phage exhibiting TM binding, internalization and then transit. Results revealed a novel set of peptides that transit across the TM to the ME in a time and temperature dependent manner. The peptides with highest transport capacities shared sequence similarities. Historically, the TM was viewed as an impermeable barrier. However, our studies reveal that it is possible to translocate peptide-linked small particles across the TM. This is the first comprehensive biopanning for the isolation of TM transiting peptidic ligands. The identified mechanism offers a new drug delivery platform into the ME. PMID:26946957

  19. Diseases of the middle ear in childhood

    PubMed Central

    Minovi, Amir; Dazert, Stefan

    2014-01-01

    Middle ear diseases in childhood play an important role in daily ENT practice due to their high incidence. Some of these like acute otitis media or otitis media with effusion have been studied extensively within the last decades. In this article, we present a selection of important childhood middle ear diseases and discuss the actual literature concerning their treatment, management of complications and outcome. Another main topic of this paper deals with the possibilities of surgical hearing rehabilitation in childhood. The bone-anchored hearing aid BAHA® and the active partially implantable device Vibrant Soundbridge® could successfully be applied for children. In this manuscript, we discuss the actual literature concerning clinical outcomes of these implantable hearing aids. PMID:25587371

  20. [Active electronic hearing implants for middle and inner ear hearing loss--a new era in ear surgery. III: prospects for inner ear hearing loss].

    PubMed

    Zenner, H P; Leysieffer, H

    1997-10-01

    The perspectives for active hearing implants lie in the treatment of patients with sensorineural hearing loss (SNHL). The majority of patients with SNHL suffer from a cochlea amplifier (CA) failure which is discernible by a positive recruitment and loss of otoacoustic emissions (OAE). Therefore, the electronic implant is expected to partially replace functions of the CA. Thus, the implant is thought to function as a CAI (cochlea amplifier implant). An approved implant for routine use is not yet available. Clinical studies have thus far only used the high energy consuming (HEC), narrow-band, electromagnetic floating-mass transducer, as well as the Maniglia-HEC implant. The high energie consuming, yet broadband Canadian Fredrickson implant is soon to be used in humans. Of the piezoelectrical implants, a German CAI (Tübingen implant) at present consisting of a piezoelectrical transducer and a microphone has thus far been acutely implanted in first patient. It is a low energy consuming (LEC), broad-band implantable system for patients with sensorineural hearing loss. Routine surgical treatment of patients with sensorineural hearing loss with a CAI will only be achieved if complete implants (with transducer, microphones, batteries, and control unit) are made available. They combine distinct acoustic superiority with invisibility (end of stigmatization), an open ear canal, and hopefully, the end of feedback whistling. Among the implants mentioned, the German CAI is the only LEC implant. Its energy requirements are so low that with today's technologie implantable batteries (e.g., in pacemakers), the additional implantation of an energy carrier seems feasible. Since the implantable microphone is already available in the German system, the only essential part missing for a totally implantable CAI is the implantable control unit.

  1. Activation of the IL-6/JAK/STAT3 signaling pathway in human middle ear cholesteatoma epithelium

    PubMed Central

    Liu, Wei; Xie, Shumin; Chen, Xing; Rao, Xingwang; Ren, Hongmiao; Hu, Bing; Yin, Tuanfang; Xiang, Yuyan; Ren, Jihao

    2014-01-01

    Interleukin-6 (IL-6) is one of the most important cytokines which has been shown to play a critical role in the pathogenesis of cholesteatoma. In this study, we aimed to investigate the expression of interleukin-6 (IL-6) and phosphorylated signal transducer and activator of transcription 3 (p-STAT3) in middle ear cholesteatoma epithelium in an effort to determine the role of IL-6/JAK/STAT3 signaling pathway in the pathogenesis of cholesteatoma. Immunohistochemistry was used to examine the expression of IL-6 and p-STAT3 in 25 human middle ear cholesteatoma samples and 15 normal external auditory canal (EAC) epithelium specimens. We also analyzed the relation of IL-6 and p-STAT3 expression levels to the degree of bone destruction in cholesteatoma. We found that the expression of IL-6 and p-STAT3 were significantly higher in cholesteatoma epithelium than in normal EAC epithelium (p<0.05). In cholesteatoma epithelium, a significant positive association was observed between IL-6 and p-STAT3 expression (p<0.05). However, no significant relationships were observed between the degree of bone destruction and the levels of IL-6 and p-STAT3 expression (p>0.05). To conclude, our results support the concept that IL-6/JAK/STAT3 signaling pathway is active and may play an important role in the mechanisms of epithelial hyper-proliferation responsible for cholesteatoma. PMID:24551293

  2. Glial choristoma of the middle ear.

    PubMed

    Shemanski, Karen A; Voth, Spencer E; Patitucci, Lana B; Ma, Yuxiang; Popnikolov, Nikolay; Katsetos, Christos D; Sataloff, Robert T

    2013-12-01

    Glial choristomas are isolated masses of mature brain tissue that are found outside the spinal cord or cranial cavity. These masses are rare, especially in the middle ear. We describe the case of an 81-year-old man who presented with left-sided chronic otitis media, mastoiditis, hearing loss, tinnitus, and aural fullness. He was found to have a glial choristoma of the middle ear on the left. Otologic surgeons should be aware of the possibility of finding such a mass in the middle ear and be familiar with the differences in treatment between glial choristomas and the more common encephaloceles.

  3. Middle Ear Adenoma: Case Report and Discussion

    PubMed Central

    Vrugt, B.; Huber, A. M.

    2014-01-01

    Introduction. Despite modern radiological workup, surgeons can still be surprised by intraoperative findings or by the pathologist's report. Materials & Methods. We describe the case of a 52-year-old male who was referred to our clinic with a single sided conductive hearing loss. He ultimately underwent middle ear exploration and excision of a middle ear tumour followed by second look and ossiculoplasty a year later. Results. Though preoperative CT and MRI scanning were suggestive of a congenital cholesteatoma, the pathologist's report diagnosed a middle ear adenoma. Discussion. Middle ear glandular tumors are extremely rare and, despite numerous histological techniques, continue to defy satisfactory classification. Most surgeons advocate surgical excision though evidence of the tumour's natural course and risk of recurrence is lacking. PMID:25045567

  4. 21 CFR 874.3430 - Middle ear mold.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Middle ear mold. 874.3430 Section 874.3430 Food... DEVICES EAR, NOSE, AND THROAT DEVICES Prosthetic Devices § 874.3430 Middle ear mold. (a) Identification. A middle ear mold is a preformed device that is intended to be implanted to reconstruct the middle...

  5. 21 CFR 874.3430 - Middle ear mold.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Middle ear mold. 874.3430 Section 874.3430 Food... DEVICES EAR, NOSE, AND THROAT DEVICES Prosthetic Devices § 874.3430 Middle ear mold. (a) Identification. A middle ear mold is a preformed device that is intended to be implanted to reconstruct the middle...

  6. 21 CFR 874.3430 - Middle ear mold.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Middle ear mold. 874.3430 Section 874.3430 Food... DEVICES EAR, NOSE, AND THROAT DEVICES Prosthetic Devices § 874.3430 Middle ear mold. (a) Identification. A middle ear mold is a preformed device that is intended to be implanted to reconstruct the middle...

  7. 3D finite element model of the chinchilla ear for characterizing middle ear functions.

    PubMed

    Wang, Xuelin; Gan, Rong Z

    2016-10-01

    Chinchilla is a commonly used animal model for research of sound transmission through the ear. Experimental measurements of the middle ear transfer function in chinchillas have shown that the middle ear cavity greatly affects the tympanic membrane (TM) and stapes footplate (FP) displacements. However, there is no finite element (FE) model of the chinchilla ear available in the literature to characterize the middle ear functions with the anatomical features of the chinchilla ear. This paper reports a recently completed 3D FE model of the chinchilla ear based on X-ray micro-computed tomography images of a chinchilla bulla. The model consisted of the ear canal, TM, middle ear ossicles and suspensory ligaments, and the middle ear cavity. Two boundary conditions of the middle ear cavity wall were simulated in the model as the rigid structure and the partially flexible surface, and the acoustic-mechanical coupled analysis was conducted with these two conditions to characterize the middle ear function. The model results were compared with experimental measurements reported in the literature including the TM and FP displacements and the middle ear input admittance in chinchilla ear. An application of this model was presented to identify the acoustic role of the middle ear septa-a unique feature of chinchilla middle ear cavity. This study provides the first 3D FE model of the chinchilla ear for characterizing the middle ear functions through the acoustic-mechanical coupled FE analysis.

  8. 3D finite element model of the chinchilla ear for characterizing middle ear functions.

    PubMed

    Wang, Xuelin; Gan, Rong Z

    2016-10-01

    Chinchilla is a commonly used animal model for research of sound transmission through the ear. Experimental measurements of the middle ear transfer function in chinchillas have shown that the middle ear cavity greatly affects the tympanic membrane (TM) and stapes footplate (FP) displacements. However, there is no finite element (FE) model of the chinchilla ear available in the literature to characterize the middle ear functions with the anatomical features of the chinchilla ear. This paper reports a recently completed 3D FE model of the chinchilla ear based on X-ray micro-computed tomography images of a chinchilla bulla. The model consisted of the ear canal, TM, middle ear ossicles and suspensory ligaments, and the middle ear cavity. Two boundary conditions of the middle ear cavity wall were simulated in the model as the rigid structure and the partially flexible surface, and the acoustic-mechanical coupled analysis was conducted with these two conditions to characterize the middle ear function. The model results were compared with experimental measurements reported in the literature including the TM and FP displacements and the middle ear input admittance in chinchilla ear. An application of this model was presented to identify the acoustic role of the middle ear septa-a unique feature of chinchilla middle ear cavity. This study provides the first 3D FE model of the chinchilla ear for characterizing the middle ear functions through the acoustic-mechanical coupled FE analysis. PMID:26785845

  9. Structure and function of the mammalian middle ear. I: Large middle ears in small desert mammals.

    PubMed

    Mason, Matthew J

    2016-02-01

    Many species of small desert mammals are known to have expanded auditory bullae. The ears of gerbils and heteromyids have been well described, but much less is known about the middle ear anatomy of other desert mammals. In this study, the middle ears of three gerbils (Meriones, Desmodillus and Gerbillurus), two jerboas (Jaculus) and two sengis (elephant-shrews: Macroscelides and Elephantulus) were examined and compared, using micro-computed tomography and light microscopy. Middle ear cavity expansion has occurred in members of all three groups, apparently in association with an essentially 'freely mobile' ossicular morphology and the development of bony tubes for the middle ear arteries. Cavity expansion can occur in different ways, resulting in different subcavity patterns even between different species of gerbils. Having enlarged middle ear cavities aids low-frequency audition, and several adaptive advantages of low-frequency hearing to small desert mammals have been proposed. However, while Macroscelides was found here to have middle ear cavities so large that together they exceed brain volume, the bullae of Elephantulus are considerably smaller. Why middle ear cavities are enlarged in some desert species but not others remains unclear, but it may relate to microhabitat.

  10. Middle ear cholesteatoma in 11 dogs

    PubMed Central

    Greci, Valentina; Travetti, Olga; Di Giancamillo, Mauro; Lombardo, Rocco; Giudice, Chiara; Banco, Barbara; Mortellaro, Carlo M.

    2011-01-01

    Middle ear cholesteatoma is a rare condition in dogs with chronic otitis. Otorrhea, otodinia, and pain on temporomandibular joint palpation are the most common clinical signs. Neurological abnormalities are often detectable. Computed tomography reveals the presence of an expansive and invasive unvascularized lesion involving the tympanic cavity and the bulla, with little or no contrast enhancement after administration of contrast mediu. Video-otoscopy may detect pearly growth or white/yellowish scales in the middle ear cavity. Surgery is the only therapy but is associated with a high risk of recurrence. PMID:22131579

  11. Salivary gland choristoma of the middle ear.

    PubMed

    Bottrill, I D; Chawla, O P; Ramsay, A D

    1992-07-01

    A salivary gland choristoma is an extremely uncommon tumour in the middle ear space. It appears to be a developmental abnormality and may be associated with abnormalities of adjacent structures. It usually presents with unilateral conductive deafness which may be long-standing and the tumour often pursues a benign, slow growing course. It is usually possible to excise it, but problems may arise as there may be variable associated anatomical abnormalities of the middle ear. We present the nineteenth recorded case, review the literature and discuss the management of this condition.

  12. Carcinoid tumor of the middle ear.

    PubMed

    Nikanne, Elina; Kantola, Olli; Parviainen, Tapani

    2004-08-01

    Although carcinoid tumors are labeled as neuroendocrine tumors they can also originate in tissue lacking neuroendocrine cells, such as that in the middle ear. Symptoms of a carcinoid tumor in the middle ear are common ear symptoms such as fullness, pain and hearing loss. Carcinoid tumors have also been considered to be slow-growing. Both these aspects can easily lead to a relatively late diagnosis of carcinoid tumor of the middle ear. The diagnosis is made histologically, and the tumor is primarily treated surgically. In the follow-up of patients, octreotide scanning has proved to be a sensitive method in cases of both recurrence and metastasis. Our patient was a 34-year-old, otherwise healthy female with left-sided acute otitis media and facial palsy in her left ear. She had also suffered from the same symptoms 4 years earlier. She was treated with an operation, and the histologic diagnosis was a carcinoid tumor. In the follow-up of the patient we used octreotide scanning.

  13. [Immunohistochemical studies with middle ear mucosal remnants in cholesteatoma].

    PubMed

    Sudhoff, H; Borkowski, G; Bujia, J; Hildmann, H; Fisseler-Eckhoff, A

    1997-08-01

    The development of a middle ear cholesteatoma is usually associated with chronic inflammation and displacement of the mucosa present by the invading squamous epithelium. To analyze the clinically different behaviors of both epithelia, we used immunohistochemical methods to study the distribution and expression of interleukin-1 (Il-1), transforming growth factor-alpha (TGF-alpha), epidermal growth factor (EGF), epidermal growth factor-receptor (EGF-R), the proliferation marker MIB 1, c-myc proto-oncogene product and activation marker 4F2. Results stromal that keratinocytes in a cholesteatoma exhibited a much higher activation and proliferation rate when compared to middle ear mucosa cells. Middle ear epithelial cells showed no immunoreactivity for TGF-alpha, EGF-R, Il-1 and c-myc in contrast to the markedly positive immunoreactivity found in cholesteatoma matrix. The local release of cytokines and growth factors, such as TGF-alpha, EGF and Il-1 by inflammatory cells seems to be an important factor for the hyper-proliferative behavior of cholesteatoma epithelium. Our findings could contribute to the pathogenesis of middle ear cholesteatoma and give a possible explanation for the sustained progression of its growth leading to displacement of the middle ear mucosa.

  14. Adenomatous tumors of the middle ear.

    PubMed

    Batsakis, J G

    1989-09-01

    Primary adenomatous tumors of the middle ear are preponderantly benign, resectable lesions and arise from the mucosa (adenomas) or salivary tissue (choristomas). Malignant variants are ill defined, are not characterized histologically, and represent less than 10% of the adenomatous tumors. Their presence may be signaled clinically by facial nerve paralysis, invasion of bone, and chronic otorrhea.

  15. Middle Ear Infection (Chronic Otitis Media) and Hearing Loss

    MedlinePlus

    ... You Middle Ear Infection (Chronic Otitis Media) and Hearing Loss Middle Ear Infection (Chronic Otitis Media) and Hearing ... learning important speech and language skills. Types of hearing loss Conductive hearing loss is a form of hearing ...

  16. Total implantation of the active hearing implant TICA for middle ear disease: a temporal bone study.

    PubMed

    Maassen, M M; Lehner, R; Leysieffer, H; Baumann, I; Zenner, H P

    2001-10-01

    A subpopulation of hearing-impaired patients has conductive hearing loss that cannot be improved by classic tympanoplasty. Other patients have a mixed hearing loss and cannot be helped by present forms of ear surgery or by hearing aids. Possible help for some patients may come from current implantable hearing devices if these are modified for the patient's specific anatomic situation. The TICA LZ 3001 is a hearing implant for total implantation used to treat moderate to severe sensorineural hearing loss. Most patients who use it have a normal ossicular chain that allows coupling of the implant to the incus. The present temporal bone study demonstrates that the TICA can also be used in patients with an interrupted ossicular chain. If the incus long process shows a defect, the TICA may be coupled to the incus body, and connection between the stapes and the long process of the incus can be achieved with a commercially available titanium-angle prosthesis or liquid ionomeric cement. In cases of an absent incus, the coupling axis of the transducer may be coupled to the stapes head via a modified coupling element. With an absent stapes, the coupling axis may be coupled directly to the perilymph by a coupling element similar to a gold stapes prosthesis.

  17. 21 CFR 874.3430 - Middle ear mold.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES EAR, NOSE, AND THROAT DEVICES Prosthetic Devices § 874.3430 Middle ear mold. (a) Identification. A middle ear mold is a preformed device that is intended to be implanted to reconstruct the middle...

  18. 21 CFR 874.3430 - Middle ear mold.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES EAR, NOSE, AND THROAT DEVICES Prosthetic Devices § 874.3430 Middle ear mold. (a) Identification. A middle ear mold is a preformed device that is intended to be implanted to reconstruct the middle...

  19. Endoscopic anatomy of the pediatric middle ear.

    PubMed

    Isaacson, Glenn

    2014-01-01

    Traditionally, otologists have aimed to produce a clean, dry, safe ear with the best possible hearing result. More recently, "less invasively" has been added to this list of goals. The development of small-diameter, high-quality rigid endoscopes and high-definition video systems has made totally endoscopic, transcanal surgery a reality in adult otology and a possibility in pediatric otology. This article reviews the anatomy of the pediatric middle ear and its surrounding airspaces and structures based on the work of dozens of researchers over the past 50 years. It will focus on the developmental changes in ear anatomy from birth through the first decade, when structure and function change most rapidly. Understanding the limits and possibilities afforded by new endoscopic technologies, the pediatric otologist can strive for results matching or exceeding those achieved by more invasive surgical approaches.

  20. [The tempestuous history of middle ear operation].

    PubMed

    Betlejewski, Stanisław; Betlejewski, Andrzej

    2008-01-01

    The paper is a review of primary and secondary historical and scientific literature concerning the surgical treatment of the middle ear diseases. The development of mastoid surgery can be traced through the past 4 centuries. Once used as a means of evacuating a postauricular abscess, it has evolved to become a method for gaining entry into the middle ear to control acute and chronic ear diseases, or for treatment of otogenic complications. Earlier works led the way to the postauricular "Wilde incision", which gave rise to Schwartze mastoidectomy. Oscar Wilde's ultimate demise from an otogenic meningitis appears all the more ironic when one considers the role his father, Sir William Wilde, played as one of the founding fathers of modern otology. The death of baron von Berger after mastoidectomy performed for treatment of tinnitus and hypacusis, stopped the further development of surgical procedures for about hundred years. The Joseph Toynbee's "Diseases of the ear" was the first work about ear diseases on a pathologic anatomical base, and fundamental for otology of the German speaking countries in the nineteenth and early twentieth centuries. Otology was emerging as a specific specialty. Von Tröltsch was the first surgeon, who proposed the antral opening through the external ear canal. When Schwartze and his assistant, Eysell, published their paper: "On the Artificial Opening of the Mastoid Air Cells," a century or so had passed since the few previous attempts to remove the tegmen of the mastoid had been reported. One of the greatest otologists of the 19th century was Adam Politzer, His influence on the 50 years of otology has never been equaled. It is in his honor that the International Society of Otology bears his name.

  1. Salivary gland choristoma of the middle ear.

    PubMed

    Mischke, R E; Brackmann, D E; Gruskin, P

    1977-07-01

    We discuss the eighth reported case of a benign salivary gland tumor in the middle ear. The lesion was a smooth lobulated mass and was found to be intimately associated with the tympanic portion of the facial nerve. Recommended treatment is biopsy without attempting removal. This concept of management is supported by a report of a similar case with a 15-year follow-up.

  2. Salivary gland choristoma of the middle ear.

    PubMed

    Fois, Paolo; Giannuzzi, Anna Lisa; Paties, Carlo Terenzio; Falcioni, Maurizio

    2014-01-01

    Choristoma of the middle ear is a rare condition characterized by the presence of normal salivary gland tissue in the middle ear space. Salivary gland choristomas are benign lesions that are frequently associated with ossicular chain and facial nerve anomalies. Total surgical excision is indicated when there is no risk of damaging the facial nerve. We describe a new case of salivary gland choristoma of the middle ear, and we discuss the etiology, histologic features, and management of such lesions. Our patient was a 22-year-old woman in whom we surgically removed a whitish retrotympanic mass. Intraoperatively, we also detected an ossicular chain malformation. Histologic examination of the choristoma revealed the presence of salivary gland tissue. Furthermore, the lesion contained an extensive and previously undescribed component: a well-defined pseudostratified respiratory-type epithelium, similar to that of a normal eustachian tube. Ten months after removal of the choristoma, we surgically repaired the ossicular chain anomalies. No recurrence was noted on follow-up.

  3. Estimation of outer-middle ear transmission using DPOAEs and fractional-order modeling of human middle ear

    NASA Astrophysics Data System (ADS)

    Naghibolhosseini, Maryam

    Our ability to hear depends primarily on sound waves traveling through the outer and middle ear toward the inner ear. Hence, the characteristics of the outer and middle ear affect sound transmission to/from the inner ear. The role of the middle and outer ear in sound transmission is particularly important for otoacoustic emissions (OAEs), which are sound signals generated in a healthy cochlea, and recorded by a sensitive microphone placed in the ear canal. OAEs are used to evaluate the health and function of the cochlea; however, they are also affected by outer and middle ear characteristics. To better assess cochlear health using OAEs, it is critical to quantify the impact of the outer and middle ear on sound transmission. The reported research introduces a noninvasive approach to estimate outer-middle ear transmission using distortion product otoacoustic emissions (DPOAEs). In addition, the role of the outer and middle ear on sound transmission was investigated by developing a physical/mathematical model, which employed fractional-order lumped elements to include the viscoelastic characteristics of biological tissues. Impedance estimations from wideband refectance measurements were used for parameter fitting of the model. The model was validated comparing its estimates of the outer-middle ear sound transmission with those given by DPOAEs. The outer-middle ear transmission by the model was defined as the sum of forward and reverse outer-middle ear transmissions. To estimate the reverse transmission by the model, the probe-microphone impedance was calculated through estimating the Thevenin-equivalent circuit of the probe-microphone. The Thevenin-equivalent circuit was calculated using measurements in a number of test cavities. Such modeling enhances our understanding of the roles of different parts of the outer and middle ear and how they work together to determine their function. In addition, the model would be potentially helpful in diagnosing pathologies of

  4. [Materials for reconstruction of the middle ear].

    PubMed

    Geyer, G

    1999-02-01

    To rehabilitate most cases of conductive hearing loss closure of ear drum perforations and rebuilding of the ossicular chain can be performed. Due to the great number of biocompatible bone substitute materials available it is occasionally difficult for the surgeon to choose the most favorable substitute. Autogenous structures (ossicles, cortical bone, cartilage) and allogenous tissues (ossicles, cortical bone, cartilage, dentin) are possible bone replacement materials. Xenogenic tissue is currently not used in middle ear surgery. Ionomer cement is a hybrid material for replacement of bone but does not fit direct classification of the various classes of alloplastic materials in current use: that is, metals (gold, steel wire, platinum, titanium), plastics (polyethylene, polytetrafluorethylene) and ceramics (ceramic oxide, carbon, calcium-phosphate ceramic, vitreous ceramic). For restoration of the sound conductive apparatus preference is given to autogenous ossicles because cortical bone is resorbed and cartilage weakens over time. Most surgeons do not use allogenous tissue, because of the possible transmission of such infectious disease as immunodeficiency syndrome or Creutzfeldt-Jakob disease. Only dentin deserves special attention as a possible bone substitute in the middle ear because its form can be preserved during sterilization. Based on the observations available to date, it becomes apparent that titanium implants hold greater promise than gold. Form-stable synthetic materials are not generally recommended due to foreign body reactions which have been confirmed by many investigators. Ceramic materials (e.g. ceramic oxide, carbon, calcium-phosphate ceramic, glass ceramic) are well tolerated in the middle ear and have also proved to be useful over time. Hybrid bone substitute ionomer cement is easily workable and well integrated, showing a good functional outcome. For many years good results in otosclerosis surgery have been achieved with a prosthesis made of

  5. The development of the mammalian outer and middle ear.

    PubMed

    Anthwal, Neal; Thompson, Hannah

    2016-02-01

    The mammalian ear is a complex structure divided into three main parts: the outer; middle; and inner ear. These parts are formed from all three germ layers and neural crest cells, which have to integrate successfully in order to form a fully functioning organ of hearing. Any defect in development of the outer and middle ear leads to conductive hearing loss, while defects in the inner ear can lead to sensorineural hearing loss. This review focuses on the development of the parts of the ear involved with sound transduction into the inner ear, and the parts largely ignored in the world of hearing research: the outer and middle ear. The published data on the embryonic origin, signalling, genetic control, development and timing of the mammalian middle and outer ear are reviewed here along with new data showing the Eustachian tube cartilage is of dual embryonic origin. The embryonic origin of some of these structures has only recently been uncovered (Science, 339, 2013, 1453; Development, 140, 2013, 4386), while the molecular mechanisms controlling the growth, structure and integration of many outer and middle ear components are hardly known. The genetic analysis of outer and middle ear development is rather limited, with a small number of genes often affecting either more than one part of the ear or having only very small effects on development. This review therefore highlights the necessity for further research into the development of outer and middle ear structures, which will be important for the understanding and treatment of conductive hearing loss.

  6. Functional characterization of middle ear mucosa residues in cholesteatoma samples.

    PubMed

    Sudhoff, H; Bujía, J; Holly, A; Kim, C; Fisseler-Eckhoff, A

    1994-03-01

    Cholesteatoma epithelium is characterized by a keratinocyte dysregulation with an aggressive growth that leads to the destruction of normal middle ear mucosa. The abnormal behavior of cholesteatoma epithelium seems to be induced by the presence of a heavy immune cell infiltrate releasing different cytokines and growth factors in high amounts. Middle ear mucosa rests are often observed within the cholesteatoma stroma or adjacent to the advancing front of cholesteatoma epithelium. This study investigated the presence of interleukin-1 (IL-1), transforming growth factor-alpha (TGF-alpha), epidermal growth factor (EGF), and epidermal growth factor-receptor (EGF-R) in the mucosa rests as well as the expression of an activation marker, 4F2. The findings were correlated with the features of a surrounding stroma with an enhanced immune cell infiltrate. Cholesteatoma epithelium showed a high staining intensity of IL-1, TGF-alpha, and EGF-R. In contrast to this, middle ear mucosa did not show any positive reactions for the mentioned factors. Epidermal growth factor immunoreactivity was found in neither cholesteatoma epithelium nor in middle ear mucosa residues. The authors found a high concentration of lymphocytes and macrophages in the surrounding stroma. Most of these cells expressed TGF-alpha, IL-1, and 4F2, suggesting an activated form. Results indicate that keratinocytes present in the middle ear mucosa do not appear to react to the stimuli released by the inflamed stroma, reflecting important differences in the cell biological features of the keratinocytes that form parts of both types of epithelium.

  7. Numerical simulation of the human ear and the dynamic analysis of the middle ear sound transmission

    NASA Astrophysics Data System (ADS)

    Yao, W.; Ma, J.; Huang, X.

    2013-06-01

    Based on the clinical CT of normal right ear, a 3-D ?nite element (FE) model of the human ear consisting of the external ear canal, middle ear(tympanic membrane, ossicular chain, ligaments, tendons), and inner ear (including semicircular canals, vestibular, spiral cochlear)was constructed in this paper. The complicated structures and inner boundary conditions of middle ear were described in this model. Model analysis and acoustic-structure-?uid coupled dynamic frequency response analysis were conducted on the model. The validity of this model was confirmed by comparing the results with published experimental data. The amplitudes and velocities of tympanic membrane and stapes footplate, sound pressure gain across the middle ear, and the cochlear input impedance were derived. Besides, it was concluded that the ear canal can amplify the sound signal in low frequencies.The modes of vibration of middle ear auditory ossicles, oval window and round window have been analysed. This model can well simulate the acoustic behavior with the interaction of external ear, middle ear and inner ear, which can supply more valuable theoretical support for development and improvement of hearing-aid and artificial inner ear.

  8. The middle ear immune defense changes with age.

    PubMed

    Nielsen, Michelle Christine; Friis, Morten; Martin-Bertelsen, Tomas; Winther, Ole; Friis-Hansen, Lennart; Cayé-Thomasen, Per

    2016-01-01

    Otitis media is a common disease in childhood. In adults, the disease is relatively rare, but more frequently associated with complications. Possible reasons for this discrepancy are age-related differences in pathogen exposure, anatomy of the Eustachian tube and immune system. The objective of this study was to analyze the relationship between age and the mucosal immune system in the middle ear. It is hypothesized that genes involved in the middle ear immune system will change with age. A comprehensive assessment of these genetic differences using the techniques of complementary DNA has not been performed. Complementary DNA microarray technology was used to identify immune-related genes differentially expressed between the normal middle ear mucosa of young (10 days old) and adult rats (80 days old). Data were analyzed using tools of bioinformatics. A total of 260 age-related genes were identified, of which 51 genes were involved in the middle ear mucosal immune system. Genes related to the innate immune system, including alpha-defensin, calcium-binding proteins S100A9 and S100A8, were upregulated in young rats, whereas genes related to the adaptive immune system, including CD3 molecules, zeta-chain T-cell receptor-associated protein kinase and linker of activated T-cells, were upregulated in the adult. This study concludes that the normal middle ear immune system changes with age. Genes related to the innate immune system are upregulated in young rats, whereas genes related to the adaptive immune system are upregulated in adults.

  9. Computed Tomography Staging of Middle Ear Cholesteatoma

    PubMed Central

    Razek, Ahmed Abdel Khalek Abdel; Ghonim, Mohamed Rashad; Ashraf, Bassem

    2015-01-01

    Summary Background To establish computed tomography (CT) staging of middle ear cholesteatoma and assess its impact on the selection of the surgical procedure. Material/Methods Prospective study was conducted on 61 consecutive patients (mean age 26.8 years) with middle ear cholesteatoma. CT scan of the temporal bone and surgery were performed in all patients. CT staging classified cholesteatoma according to its location in the tympanic cavity (T); extension into the mastoid (M); and associated complications (C). Cholesteatoma was staged as stage I (T1, T2), stage II (T3, M1, M2, C1), and stage III (C2). Results The overall sensitivity of CT staging of cholesteatoma compared to surgery was 88% with excellent agreement and correlation between CT findings and intra-operative findings (K=0.863, r=0.86, P=0.001). There was excellent agreement and correlation of CT staging with surgical findings for T location (K=0.811, r=0.89, P=0.001), good for M extension (K=0.734, r=0.88, P=0.001), and excellent for associated C complications (K=1.00, r=1.0, P=0.001). Atticotympanotomy was carried out in stage I (n=14), intact canal wall surgery was performed in stage II (n=38), and canal wall down surgery was done in stage III (n=5) and stage II (n=4). Conclusions We established CT staging of middle ear cholesteatoma that helps surgeons to select an appropriate surgery. PMID:26171086

  10. LDV measurement of bird ear vibrations to determine inner ear impedance and middle ear power flow

    NASA Astrophysics Data System (ADS)

    Muyshondt, Pieter G. G.; Pires, Felipe; Dirckx, Joris J. J.

    2016-06-01

    The mechanical behavior of the middle ear structures in birds and mammals is affected by the fluids in the inner ear (IE) that are present behind the oval window. In this study, the aim was to gather knowledge of the acoustic impedance of the IE in the ostrich, to be able to determine the effect on vibrations and power flow in the single-ossicle bird middle ear for future studies. To determine the IE impedance, vibrations of the ossicle were measured for both the quasi-static and acoustic stimulus frequencies. In the acoustic regime, vibrations were measured with a laser Doppler vibrometer and electromagnetic stimulation of the ossicle. The impedance of the inner ear could be determined by means of a simple RLC model in series, which resulted in a stiffness reactance of KIE = 0.20.1012 Pa/m3, an inertial impedance of MIE = 0.652.106 Pa s2/m3, and a resistance of RIE = 1.57.109 Pa s/m. The measured impedance is found to be considerably smaller than what is found for the human IE.

  11. A case report of meningioma extending to the middle ear

    PubMed Central

    Kusunoki, Takeshi; Ikeda, Katsuhisa; Miyashita, Mie

    2012-01-01

    Extracranial meningioma with extension into a middle ear is very uncommon. A 74-year-old female was admitted to our hospital with right ear bleeding when removing earwax. In this case, magnetic resonance imaging, computed tomography, her past history and operative findings would consider as infiltrative growth from the right sphenoid ridge meningioma to the right middle ear via the right petrous pyramid and bilateral optic nerve. She underwent only partial extirpation with decompression for optic nerve, rather than total extirpation including middle ear and temporal bone, due to wide invasion of the middle cranial fossa and caversinus sinus. PMID:24765466

  12. Neuroendocrine Adenoma of the Middle Ear: A Rare Histopathological Diagnosis

    PubMed Central

    McGinness, Sam; Coleman, Hedley; Varikatt, Winny; da Cruz, Melville

    2016-01-01

    Neuroendocrine tumours occur throughout the body but are rare in the head and neck region and particularly rare in the middle ear. Clinical findings are often nonspecific and therefore pose a diagnostic challenge. Furthermore, the nomenclature of neuroendocrine tumours of the middle ear is historically controversial. Herein a case is presented of a middle ear adenoma in a 33-year-old patient who presented with otalgia, hearing loss, and facial nerve palsy. A brief discussion is included regarding the histopathological features of middle ear adenomas and seeks to clarify the correct nomenclature for these tumours. PMID:27429819

  13. Middle-ear velocity transfer function, cochlear input immittance, and middle-ear efficiency in chinchilla.

    PubMed

    Ravicz, Michael E; Rosowski, John J

    2013-10-01

    The transfer function H(V) between stapes velocity V(S) and sound pressure near the tympanic membrane P(TM) is a descriptor of sound transmission through the middle ear (ME). The ME power transmission efficiency (MEE), the ratio of sound power entering the cochlea to power entering the middle ear, was computed from H(V) measured in seven chinchilla ears and previously reported measurements of ME input admittance Y(TM) and ME pressure gain G(MEP) [Ravicz and Rosowski, J. Acoust. Soc. Am. 132, 2437-2454 (2012); J. Acoust. Soc. Am. 133, 2208-2223 (2013)] in the same ears. The ME was open, and a pressure sensor was inserted into the cochlear vestibule for most measurements. The cochlear input admittance Y(C) computed from H(V) and G(MEP) is controlled by a combination of mass and resistance and is consistent with a minimum-phase system up to 27 kHz. The real part Re{Y(C)}, which relates cochlear sound power to inner-ear sound pressure, decreased gradually with frequency up to 25 kHz and more rapidly above that. MEE was about 0.5 between 0.1 and 8 kHz, higher than previous estimates in this species, and decreased sharply at higher frequencies.

  14. Study Suggests Genetic Link to Middle Ear Infections

    MedlinePlus

    ... medlineplus.gov/news/fullstory_161378.html Study Suggests Genetic Link to Middle Ear Infections They're the ... News) -- Researchers say they've found a potential genetic link to a child's higher risk of middle ...

  15. CT of adenomas of the middle ear and mastoid cavity

    SciTech Connect

    Van Thong Ho; Rao, V.J.; Mikaelian, D.O.

    1996-03-01

    A case of mixed type adenoma of the middle ear and mastoid is presented in which CT showed complete opacification of the middle ear and mastoid air cells with bulging of the tympanic membrane but without ossicular or bony destruction. 7 refs., 1 figs.

  16. Interleukin 1 (IL-1) and IL-1-receptor antagonist (IL-1-RA) in middle ear cholesteatoma: an analysis of protein production and biological activity.

    PubMed

    Bujía, J; Kim, C; Ostos, P; Sudhoff, H; Kastenbauer, E; Hültner, L

    1996-01-01

    Cytokine networks are now presumed to play an essential role in the pathogenesis of middle ear cholesteatoma. Of the factors identified in cholesteatoma, interleukin-I (IL-1)-alpha appears to be especially important because of its stimulation of keratinocyte proliferation as well induction of bone resorption. To further characterize the possible role of IL-1 in the pathogenesis of cholesteatoma, we quantified the levels of IL-1 and IL-1-receptor antagonist (IL-1-RA) present using the bicinchonic acid protein assay and enzyme-linked immunosorbent assay (ELISA) on tissue extracts from 20 cholesteatoma specimens. The presence of biologically active IL-1 was also analyzed, using the cell line LBRM-33 and an ELISA for the detection of interleukin-2 (IL-2). Human skin obtained from the external ear canal was used as control. The amounts of IL-1-alpha in cholesteatoma (34.9 +/- 19.5) were higher than in human skin (6.7 +/- 2.8). The observed differences were statistically significant by Student's t-test (P < 0.01). Skin samples showed elevated concentrations of IL-1-RA (248.3 +/- 30.2) in comparison to that in the cholesteatoma (80.8 +/- 13.5). This was also statistically significant (P < 0.01). Whereas IL-1 activity was not detected in skin samples, all cholesteatoma specimens studied showed a stimulation effect on the production of IL-2 when incubated with the cell line LBRM-33. The results point to an over-expression of IL-1 concurrent with a decreased secretion of IL-1-RA in middle ear cholesteatoma. Furthermore IL-1-RA production is deficient relative to total IL-1 production, resulting in the presence of active IL-1.

  17. Tympanometric evaluation of middle ear barotrauma during recreational scuba diving.

    PubMed

    Green, S M; Rothrock, S G; Green, E A

    1993-10-01

    We report the first prospective evaluation of middle ear barotrauma in experienced recreational scuba divers. In this pilot study, tympanometric and otoscopic evaluations were performed daily on two experienced scuba divers engaged in multi-day repetitive diving. Middle ear pressures decreased in proportion to diving frequency, demonstrating eustachian tube dysfunction which promptly reversed upon cessation of diving Otoscopic evidence of traumatic injury to the middle ear occurred in proportion to diving frequency, and also readily reversed upon cessation of diving. Tympanic membrane compliance remained normal, often despite pronounced otoscopic abnormalities. Otologic symptoms and impairment of acuity were not observed. Tympanometry appears to be a valuable modality for the verification of middle ear hemorrhage or tympanic membrane rupture. This preliminary data should assist investigators in planning more comprehensive studies of middle ear barotrauma, including clinical trials of treatment and prophylactic interventions for this common condition.

  18. Scanning laser Doppler vibrometry of the middle ear ossicles.

    PubMed

    Ball, G R; Huber, A; Goode, R L

    1997-04-01

    This paper describes measurements of the vibratory modes of the middle ear ossicles made with a scanning laser Doppler vibrometer. Previous studies of the middle ear ossicles with single-point laser Doppler measurements have raised questions regarding the vibrational modes of the ossicular chain. Single-point analysis methods do not have the ability to measure multiple points on the ossicles and, consequently, have limited ability to simultaneously record relative phase information at these points. Using a Polytec Model PSV-100, detailed measurements of the ossicular chain have been completed in the human temporal bone model. This model, when driven with a middle ear transducer, provides detailed three-dimensional data of the vibrational patterns of the middle ear ossicles. Implications for middle ear implantable devices are discussed.

  19. Prolonged Radiant Exposure of the Middle Ear during Transcanal Endoscopic Ear Surgery.

    PubMed

    Shah, Parth V; Kozin, Elliott D; Remenschneider, Aaron K; Dedmon, Matthew M; Nakajima, Hideko Heidi; Cohen, Michael S; Lee, Daniel J

    2015-07-01

    Transcanal endoscopic ear surgery (EES) provides a high-resolution, wide-field view of the middle ear compared with the conventional operating microscope, reducing the need for a postauricular incision or mastoidectomy. Our group has shown in cadaveric human temporal bone studies that radiant energy from the endoscope tip can quickly elevate temperatures of the tympanic cavity. Elevated temperatures of the middle ear are associated with acute auditory brainstem response shifts in animal models. In EES, proposed methods to decrease middle ear temperature include frequent removal of the endoscope and the use of suction to rapidly dissipate heat; however, the routine application of such cooling techniques remains unknown. Herein, we aim to quantify the duration that the tympanic cavity is typically exposed to the endoscope during routine endoscopic middle ear surgery. We find that the tympanic cavity is exposed to the endoscope without a cooling mechanism for a prolonged period of time.

  20. Temporal bone meningioma involving the middle ear: A case report

    PubMed Central

    RICCIARDIELLO, FILIPPO; FATTORE, LUCIA; LIGUORI, MARIA ESTER; OLIVA, FLAVIA; LUCE, AMALIA; ABATE, TERESA; CARAGLIA, MICHELE; PIANESE, ANNALISA; RAUCCI, ALDO FALCO

    2015-01-01

    Meningioma is a common intracranial tumor involving the meninges. The localization of this type of tumor is rarely extracranial due to its typically low invasive properties. Furthermore, invasion of the middle ear is exceptional. The present study reported a case of meningioma extending into the middle ear from the middle cranial fossa through the tegmen tympani. The clinical and pathological characteristics, as well as the outcome of the patient, were described. PMID:26622828

  1. 3D visualization of middle ear structures

    NASA Astrophysics Data System (ADS)

    Vogel, Uwe; Schmitt, Thomas

    1998-06-01

    The achievement of volume geometry data from middle ear structures and surrounding components performs a necessary supposition for the finite element simulation of the vibrational and transfer characteristics of the ossicular chain. So far those models base on generalized figures and size data from anatomy textbooks or particular manual and one- or two-dimensional distance measurements of single ossicles, mostly obtained by light microscopy, respectively. Therefore the goal of this study is to create a procedure for complete three-dimensional imaging of real middle ear structures (tympanic membrane, ossicles, ligaments) in vitro or even in vivo. The main problems are their microscopic size with relevant structures from 10 micrometer to 5 mm, representing various tissue properties (bone, soft tissue). Additionally, these structures are surrounded by the temporal bone, the most solid bone of the human body. Generally there exist several established diagnostic tools for medical imaging that could be used for geometry data acquisition, e.g., X-ray computed tomography and magnetic resonance imaging. Basically they image different tissue parameters, either bony structures (ossicles), or soft tissue (tympanic membrane, ligaments). But considering this application those standard techniques allow low spatial resolution only, usually in the 0.5 - 1mm range, at least in one spatial direction. Thus particular structures of the middle ear region could even be missed completely because of their spatial location. In vitro there is a way out by collecting three complete data sets, each distinguished by 90 degree rotation of a cube-shaped temporal bone specimen. That allows high-resolution imaging in three orthogonal planes, which essentially supports the three-dimensional interpolation of the unknown elements, starting from the regularly set elements of the cubic grid with an edge extension given by the original two-dimensional matrix. A different approach represents the

  2. Can you hear me now? Understanding vertebrate middle ear development.

    PubMed

    Chapman, Susan Caroline

    2011-01-01

    The middle ear is a composite organ formed from all three germ layers and the neural crest. It provides the link between the outside world and the inner ear, where sound is transduced and routed to the brain for processing. Extensive classical and modern studies have described the complex morphology and origin of the middle ear. Non-mammalian vertebrates have a single ossicle, the columella. Mammals have three functionally equivalent ossicles, designated the malleus, incus and stapes. In this review, I focus on the role of genes known to function in the middle ear. Genetic studies are beginning to unravel the induction and patterning of the multiple middle ear elements including the tympanum, skeletal elements, the air-filled cavity, and the insertion point into the inner ear oval window. Future studies that elucidate the integrated spatio-temporal signaling mechanisms required to pattern the middle ear organ system are needed. The longer-term translational benefits of understanding normal and abnormal ear development will have a direct impact on human health outcomes.

  3. Can you hear me now? Understanding vertebrate middle ear development.

    PubMed

    Chapman, Susan Caroline

    2011-01-01

    The middle ear is a composite organ formed from all three germ layers and the neural crest. It provides the link between the outside world and the inner ear, where sound is transduced and routed to the brain for processing. Extensive classical and modern studies have described the complex morphology and origin of the middle ear. Non-mammalian vertebrates have a single ossicle, the columella. Mammals have three functionally equivalent ossicles, designated the malleus, incus and stapes. In this review, I focus on the role of genes known to function in the middle ear. Genetic studies are beginning to unravel the induction and patterning of the multiple middle ear elements including the tympanum, skeletal elements, the air-filled cavity, and the insertion point into the inner ear oval window. Future studies that elucidate the integrated spatio-temporal signaling mechanisms required to pattern the middle ear organ system are needed. The longer-term translational benefits of understanding normal and abnormal ear development will have a direct impact on human health outcomes. PMID:21196256

  4. Laser vibrometer measurements and middle ear prostheses

    NASA Astrophysics Data System (ADS)

    Flock, Stephen T.; Dornhoffer, John; Ferguson, Scott

    1997-05-01

    One of us has developed an improved partial ossicular replacement prosthesis that is easier to implant and, based on pilot clinical measurements, results in better high-frequency hearing as compared to patients receiving one of the alternative prostheses. It is hypothesized that the primary reason for this is because of the relatively light weight (about 25 mg) and low compliance of the prosthesis, which could conceivably result in better high frequency vibrational characteristics. The purpose of our initial work was to develop an instrument suitable for objectively testing the vibrational characteristics of prostheses. We have developed a laser based device suitable for measuring the vibrational characteristics of the oval window or other structures of the middle ear. We have tested this device using a piezoelectric transducer excited at audio frequencies, as well as on the oval window in human temporal bones harvested from cadavers. The results illustrate that it is possible to non-invasively monitor the vibrational characteristics of anatomic structures with a very inexpensive photonic device.

  5. Oral Pseudoephedrine Decreases the Rate of Trans-mucosal Nitrous Oxide Exchange for the Middle Ear

    PubMed Central

    Teixeira, Miriam S.; Alper, Cuneyt M.; Martin, Brian S; Cullen Doyle, Brendan M.; Doyle, William J.

    2015-01-01

    Objective Determine if oral pretreatment with a vasoconstrictor decreases the blood to middle-ear exchange-rate of the perfusion-limited gas, Nitrous Oxide (N2O). Study Design Randomized, double-blind, crossover study. Methods Ten adult subjects with and 10 without past middle-ear disease completed paired experimental sessions, identical but for oral pretreatment with either pseudoephedrine HCL or lactose placebo. At each session, subjects were fitted with a non-rebreathing mask and breathed room air for 20 minutes (acclimation period), 50% N2O:50% O2 for 20 minutes (experimental period) and 100% O2 for 10 minutes (recovery period). Throughout, heart-rate, blood-pressure and O2 saturation were monitored and bilateral middle-ear pressures were recorded by tympanometry every minute. The primary outcome was the slope of the middle-ear pressure-time function for the experimental period which estimates the volume N2O exchange-rate. Using repeated measures ANOVA, the effects of Group (disease history), Treatment (active vs. placebo) and Period (1 vs. 2) on the recorded vital signs, and of Group, Treatment and Ear (left/right) on the middle-ear pressure-time slope were evaluated for statistical significance. Results Statistically significant effects of Period on O2 saturation (Period 2>Period 1) and of Treatment on heart-rate (Active>Placebo) were documented. Only Treatment was statistically significant for the middle-ear pressure-time slope with a shallower slope characterizing the active treatment session. Conclusion The volume exchange-rate across the middle-ear mucosa of perfusion-limited gases can be modulated pharmacologically. Theoretically, similar drugs can be used to reduce the requisite Eustachian tube opening efficiency for adequate middle-ear pressure regulation. PMID:26152838

  6. Middle Ear Resonance and Acoustic Immittance Measures in Children.

    ERIC Educational Resources Information Center

    Hanks, Wendy D.; Rose, Katie J.

    1993-01-01

    This study established a normal middle ear resonance estimated from sweep frequency tympanometry, established normal equivalent ear canal volume, static acoustic admittance, and tympanometric peak pressure at 226 hertz in 90 children with normal hearing and 68 children with deafness, ages 6-15. No significant intergroup or age differences were…

  7. Tympanostomy Tubes: A Rational Clinical Treatment for Middle Ear Disease.

    ERIC Educational Resources Information Center

    Roland, Peter S.; Brown, Orval

    1990-01-01

    The use of tympanostomy tubes to treat middle ear disease including otitis media is discussed with sections on the eustachian tube; acute otitis media; persistent effusion; changes in the tympanic membrane; special populations; and complications. (DB)

  8. An experimental technique for determining middle ear impedance.

    PubMed

    Blayney, A W; McAvoy, G J; Rice, H J; Williams, K R

    1996-03-01

    A two-microphone technique was used to determine the middle ear impedance of a live subject. The procedure involved the application of standing wave tube theory and the assumption that the ear canal behaves like an homogeneous cylinder with plane acoustic wave propagation up to a certain frequency--2 kHz for the current analysis. During experimentation the subject lay on a bench with his head braced against a wooden fixture. Acoustic pressures were recorded from the ear canal by the use of a spectrum analyser and probe microphones with flexible tips. Resultant impedance curves show middle ear natural frequencies at 831 Hz and 1,970 Hz with high levels of damping. The reactive impedance curves show the influence of stiffness and ossicular mass on middle ear sound transmission. An advantage of the approach is that using features of the recorded data it is possible to calculate the effective probe tip to eardrum distance required for the calculation of the middle ear impedance. The two-microphone technique appears to be a promising tool for assessing healthy and diseased middle ear function. PMID:8725514

  9. How minute sooglossid frogs hear without a middle ear

    PubMed Central

    Boistel, Renaud; Aubin, Thierry; Cloetens, Peter; Peyrin, Françoise; Scotti, Thierry; Herzog, Philippe; Gerlach, Justin; Pollet, Nicolas; Aubry, Jean-François

    2013-01-01

    Acoustic communication is widespread in animals. According to the sensory drive hypothesis [Endler JA (1993) Philos Trans R Soc Lond B Biol Sci 340(1292):215–225], communication signals and perceptual systems have coevolved. A clear illustration of this is the evolution of the tetrapod middle ear, adapted to life on land. Here we report the discovery of a bone conduction–mediated stimulation of the ear by wave propagation in Sechellophryne gardineri, one of the world’s smallest terrestrial tetrapods, which lacks a middle ear yet produces acoustic signals. Based on X-ray synchrotron holotomography, we measured the biomechanical properties of the otic tissues and modeled the acoustic propagation. Our models show how bone conduction enhanced by the resonating role of the mouth allows these seemingly deaf frogs to communicate effectively without a middle ear. PMID:24003145

  10. Penetrating middle ear trauma: a report of 2 cases.

    PubMed

    Neuenschwander, Michael C; Deutsch, Ellen S; Cornetta, Anthony; Willcox, Thomas O

    2005-01-01

    Penetrating middle ear injury can result in hearing loss, vertigo, and facial nerve injury. We describe the cases of 2 children with penetrating trauma to the right ear that resulted in ossicular chain disruption; one injury was caused by cotton-tipped swabs and the other by a wooden matchstick. Symptoms in both children included hearing loss and otalgia; in addition, one child experienced ataxia and the other vertigo. Physical examination in both cases revealed a perforation in the posterosuperior quadrant of the tympanic membrane and visible ossicles. Audiometry identified a moderate conductive hearing loss in one child and a mild sensorineural hearing loss in the other. Both children underwent middle ear exploration and reduction of a subluxed stapes. We discuss the diagnosis, causes, and management of penetrating middle ear trauma. To reduce the morbidity associated with these traumas, otologic surgeons should act promptly and be versatile in choosing methods of repairing ossicular chain injuries.

  11. Prevalence of middle ear disorders in coal miners

    SciTech Connect

    Lempert, B.L.; Hopkinson, N.T.; Keith, R.W.; Motl, M.L.; Horine, J.

    1981-06-01

    Results are presented from a study of the prevalence of middle and external ear disorders in coal miners who work underground. The study followed from an earlier NIOSH report (1976) that indicated a possibly large number of otoscopic abnormalities in this population of workers. Otoscopic examinations, pure tone air- and bone-conduction audiometry tests, and impedance tests were administered to 350 underground miners and 150 industrial workers not associated with mining. The study was conducted completely within a hospital otolaryngology/audiology clinic setting. Results of the investigation showed a highly similar prevalence of middle ear and ear canal abnormalities in the miner group and the control group (19 percent). Middle ear abnormalities observed in the miners were judged by the examining otolaryngologists to have preceded their experience in the mines and were not related solely to underground noise exposure or coal dust. Nearly half of the subjects who had an air-bone gap had no middle ear abnormality observable by otoscopic examination. There was substantial agreement between the finding of abnormal otoscopy and abnormal tympanometry. By itself, acoustic reflex was not useful in identifying middle ear disorders, since this reflex may be absent for other reasons, including presence of severe sensorineural hearing loss.

  12. Sound pressure gain produced by the human middle ear.

    PubMed

    Kurokawa, H; Goode, R L

    1995-10-01

    The acoustic function of the middle ear is to match sound passing from the low impedance of air to the high impedance of cochlear fluid. Little information is available on the actual middle ear pressure gain in human beings. This article describes experiments on middle ear pressure gain in six fresh human temporal bones. Stapes footplate displacement and phase were measured with a laser Doppler vibrometer before and after removal of the tympanic membrane, malleus, and incus. Acoustic insulation of the round window with clay was performed. Umbo displacement was also measured before tympanic membrane removal to assess baseline tympanic membrane function. The middle ear has its major gain in the lower frequencies, with a peak near 0.9 kHz. The mean gain was 23.0 dB below 1.0 kHz, the resonant frequency of the middle ear; the mean peak gain was 26.6 dB. Above 1.0 kHz, the second pressure gain decreased at a rate of -8.6 dB/octave, with a mean gain of 6.5 dB at 4.0 kHz. Only a small amount of gain was present above 7.0 kHz. Significant individual differences in pressure gain were found between ears that appeared related to variations in tympanic membrane function and not to variations in cochlear impedance. PMID:7567003

  13. Decrease in Middle Ear Resonance Frequency During Pregnancy

    PubMed Central

    Dag, Emine Kutlu; Gulumser, Cagri; Erbek, Seyra

    2016-01-01

    Many physiological changes occur during pregnancy. The aim of the study was to reveal whether there is a change in middle ear resonance frequency during pregnancy. A prospective case-control study was designed at a tertiary referral center. The study included 46 pregnant women at the third trimester (27-40 weeks) and 43 nonpregnant voluntary women. All the study subjects underwent pure-tone audiometry and multifrequency tympanometry. Pure-tone hearing levels at frequencies of 250 to 8000 Hz and resonance frequency values were compared between pregnant and nonpregnant women. Impact of age, side of the tested ear, and weight gained in pregnancy on resonance frequency were evaluated. Air conduction threshold values at frequencies of 250 Hz and 500 Hz were significantly higher in pregnant women than in the control group (P<0.001). Middle ear resonance frequency values of both ears in pregnant women were found to be significantly lower than those in control group (P<0.001). There was no statistically significant relation of middle ear resonance frequency values to age or side of the tested ear in both groups (P>0.05). A negative correlation between weight gained in pregnancy and middle ear resonance frequency values was determined for the left ear (correlation coefficient for left ears: –0.348, P=0.018). The results of this study suggest that resonance frequency may be decreased during the pregnancy. More comprehensive studies in which many pregnant women followed regularly before and after pregnancy are needed to have more certain links. PMID:27588163

  14. Decrease in Middle Ear Resonance Frequency During Pregnancy.

    PubMed

    Dag, Emine Kutlu; Gulumser, Cagri; Erbek, Seyra

    2016-04-20

    Many physiological changes occur during pregnancy. The aim of the study was to reveal whether there is a change in middle ear resonance frequency during pregnancy. A prospective case-control study was designed at a tertiary referral center. The study included 46 pregnant women at the third trimester (27-40 weeks) and 43 nonpregnant voluntary women. All the study subjects underwent pure-tone audiometry and multifrequency tympanometry. Pure-tone hearing levels at frequencies of 250 to 8000 Hz and resonance frequency values were compared between pregnant and nonpregnant women. Impact of age, side of the tested ear, and weight gained in pregnancy on resonance frequency were evaluated. Air conduction threshold values at frequencies of 250 Hz and 500 Hz were significantly higher in pregnant women than in the control group (P<0.001). Middle ear resonance frequency values of both ears in pregnant women were found to be significantly lower than those in control group (P<0.001). There was no statistically significant relation of middle ear resonance frequency values to age or side of the tested ear in both groups (P>0.05). A negative correlation between weight gained in pregnancy and middle ear resonance frequency values was determined for the left ear (correlation coefficient for left ears: -0.348, P=0.018). The results of this study suggest that resonance frequency may be decreased during the pregnancy. More comprehensive studies in which many pregnant women followed regularly before and after pregnancy are needed to have more certain links.

  15. Decrease in Middle Ear Resonance Frequency During Pregnancy.

    PubMed

    Dag, Emine Kutlu; Gulumser, Cagri; Erbek, Seyra

    2016-04-20

    Many physiological changes occur during pregnancy. The aim of the study was to reveal whether there is a change in middle ear resonance frequency during pregnancy. A prospective case-control study was designed at a tertiary referral center. The study included 46 pregnant women at the third trimester (27-40 weeks) and 43 nonpregnant voluntary women. All the study subjects underwent pure-tone audiometry and multifrequency tympanometry. Pure-tone hearing levels at frequencies of 250 to 8000 Hz and resonance frequency values were compared between pregnant and nonpregnant women. Impact of age, side of the tested ear, and weight gained in pregnancy on resonance frequency were evaluated. Air conduction threshold values at frequencies of 250 Hz and 500 Hz were significantly higher in pregnant women than in the control group (P<0.001). Middle ear resonance frequency values of both ears in pregnant women were found to be significantly lower than those in control group (P<0.001). There was no statistically significant relation of middle ear resonance frequency values to age or side of the tested ear in both groups (P>0.05). A negative correlation between weight gained in pregnancy and middle ear resonance frequency values was determined for the left ear (correlation coefficient for left ears: -0.348, P=0.018). The results of this study suggest that resonance frequency may be decreased during the pregnancy. More comprehensive studies in which many pregnant women followed regularly before and after pregnancy are needed to have more certain links. PMID:27588163

  16. Do Swiftlets have an ear for echolocation? The functional morphology of Swiftlets' middle ears.

    PubMed

    Thomassen, Henri A; Gea, Stefan; Maas, Steve; Bout, Ron G; Dirckx, Joris J J; Decraemer, Willem F; Povel, G David E

    2007-03-01

    The Oilbird and many Swiftlet species are unique among birds for their ability to echolocate. Echolocaters may benefit from improved hearing sensitivity. Therefore, morphological adaptations to echolocation might be present in echolocating birds' middle ears. We studied the functional morphology of the tympano-ossicular chain of seven specimens of four echolocating Swiftlet species and one specimen each of five non-echolocating species. Three dimensional (3D) reconstructions were made from micro-Computer-Tomographic (muCT) scans. The reconstructions were used in functional morphological analyses and model calculations. A two dimensional (2D) rigid rod model with fixed rotational axes was developed to study footplate output-amplitudes and to describe how changes in the arrangement of the tympano-ossicular chain affect its function. A 3D finite element model was used to predict ossicular-chain movement and to investigate the justification of the 2D approach. No morphological adaptations towards echolocation were found in the middle-ear lever system or in the mass impedance of the middle ear. A wide range of middle-ear configurations result in maximum output-amplitudes and all investigated species are congruent with these predicted best configurations. Echolocation is unlikely to depend on adaptations in the middle ear tympano-ossicular chain. PMID:17229537

  17. Epidemiology and aetiology of middle ear cholesteatoma.

    PubMed

    Kemppainen, H O; Puhakka, H J; Laippala, P J; Sipilä, M M; Manninen, M P; Karma, P H

    1999-01-01

    A total of 500 patients with cholesteatoma diagnosed and operated during 1982-91 in the region of Tampere University Hospital and Mikkeli Central Hospital in Finland were analysed retrospectively. The mean annual incidence was 9.2 per 100,000 inhabitants (range 3.7-13.9) and during the study period the annual incidence decreased significantly. The incidence was higher among males under the age of 50 years. There was no accumulation of cholesteatoma diseases in lower social groups. The majority (72.4%) of cholesteatoma patients had suffered from otitis media episodes. Tympanostomy was carried out in 10.2% and adenoidectomy or adenotonsillectomy in 15.9% of all cholesteatoma ears prior to cholesteatoma surgery. Cholesteatoma behind an intact tympanic membrane with no history of otitis media was verified in 0.6% of patients and in cleft palate patients in 8%. In this study, 13.2% of patients had ear trauma or ear operation in anamnes.

  18. Zwislocki's model of the middle ear re-visited

    NASA Astrophysics Data System (ADS)

    Withnell, Robert H.; Fields, Taylor N.

    2015-12-01

    Zwislocki's circuit model of the middle ear [11] has been used, in original or modified form, in subsequent studies modeling the ear [4, 6]. The model includes two eardrum modes of vibration, a shunt for flexible coupling between the incus and stapes, and a single tuned oscillator for ossicular vibration. The contribution of each of these mechanisms was examined by fitting a model of the ear to acoustic input impedance data from healthy human ears. The circuit elements for a non-ossicular eardrum vibration and a flexible coupling between the incus and stapes were found to be detrimental or non-essential for the model-fit-to-data. A single mode of eardrum vibration for sound transmission to the middle ear is consistent with the eardrum acting as an impedance-matching device, with pars-tensa eardrum vibration coupled to the ossicles [1]. A single-tuned oscillator was insufficient to account for the bandwidth of the ear. The frequency response of the ear suggests multiple resonant modes of ossicular vibration.

  19. Auditory Brainstem Circuits That Mediate the Middle Ear Muscle Reflex

    PubMed Central

    Mukerji, Sudeep; Windsor, Alanna Marie; Lee, Daniel J.

    2010-01-01

    The middle ear muscle (MEM) reflex is one of two major descending systems to the auditory periphery. There are two middle ear muscles (MEMs): the stapedius and the tensor tympani. In man, the stapedius contracts in response to intense low frequency acoustic stimuli, exerting forces perpendicular to the stapes superstructure, increasing middle ear impedance and attenuating the intensity of sound energy reaching the inner ear (cochlea). The tensor tympani is believed to contract in response to self-generated noise (chewing, swallowing) and nonauditory stimuli. The MEM reflex pathways begin with sound presented to the ear. Transduction of sound occurs in the cochlea, resulting in an action potential that is transmitted along the auditory nerve to the cochlear nucleus in the brainstem (the first relay station for all ascending sound information originating in the ear). Unknown interneurons in the ventral cochlear nucleus project either directly or indirectly to MEM motoneurons located elsewhere in the brainstem. Motoneurons provide efferent innervation to the MEMs. Although the ascending and descending limbs of these reflex pathways have been well characterized, the identity of the reflex interneurons is not known, as are the source of modulatory inputs to these pathways. The aim of this article is to (a) provide an overview of MEM reflex anatomy and physiology, (b) present new data on MEM reflex anatomy and physiology from our laboratory and others, and (c) describe the clinical implications of our research. PMID:20870664

  20. Soft tissue attenuation in middle ear on HRCT: Pictorial review

    PubMed Central

    Anbarasu, Arangasamy; Chandrasekaran, Kiruthika; Balakrishnan, Sivasubramanian

    2012-01-01

    Middle ear disease is a common clinical entity; imaging, especially High resolution Computed Tomography (HRCT), plays a crucial role in diagnosis and assessing the disease extent, helping to decide appropriate management. Temporal bone imaging is challenging and involves thorough understanding of the anatomy, especially in relation to HRCT imaging. Most of the middle ear pathologies appear as “soft tissue” on imaging. Careful analysis of the soft tissue on the HRCT is crucial in achieving the right diagnosis; clinical information is essential and the imaging findings need correlation with clinical presentation and otoscopic findings. The purpose of this pictorial essay is to enlist the pathologies that present as soft tissue in middle ear and to provide a structured and practical imaging approach that will serve as a guide for confident reporting in daily practice. PMID:23833422

  1. Mycological and histological investigations in humans with middle ear infections.

    PubMed

    Vennewald, I; Schönlebe, J; Klemm, E

    2003-02-01

    The aim of our investigations was to characterize fungal colonization of the ear in immunocompetent patients. From 1993 to 2000, 128 patients supposed to suffer from otomycosis were included. Mycological examination conducted by direct microscopy and fungal cultures was performed on 139 specimens. Among these, 115 patients suffered from chronic otitis media with persisting tympanum perforation and otorrhea. A further 13 patients had clinical signs of an otitis externa only. Out of 139 samples, fungi were identified in the auditory canal (n = 54), on the tympanic membrane (n = 5), and in the middle ear (n = 5). Two-thirds were as moulds and one-third yeasts. The dominating species were Aspergillus niger and Candida parapsilosis. Samples from 15 patients supposed to have mastoiditis or cholesteatoma were examined histologically. Fungal hyphae were observed in the middle ear cavity and/or between horny lamellae of cholesteatoma in four patients. In the middle ear of immunocompetent patients chronic-hyperplastic (polypoid) inflammation was detected with increased production of mucus, which probably promotes colonization by pathogenic fungi in the middle ear as well as in the auditory canal. Invasive fungal growth into the subepithelial connective tissue was not observed.

  2. Bilateral nontuberculous mycobacterial middle ear infection: a rare case.

    PubMed

    Tang, Ing Ping; Singh, Shashinder; Rajagopalan, Raman

    2014-09-01

    Nontuberculous Mycobacterium (NTM) middle ear infection is a rare cause of chronic bilateral intermittent otorrhea. We report a rare case of bilateral NTM middle ear infection in which a 55-year-old woman presented with intermittent otorrhea of 40 years' duration. The patient was treated medically with success. We conclude that NTM is a rare but probably under-recognized cause of chronic otitis media. A high index of suspicion is needed for the diagnosis to avoid prolonged morbidity. Treatment includes surgical clearance of infected tissue with appropriate antimycobacterial drugs, which are selected based on culture and sensitivity.

  3. Independent origins of middle ear bones in monotremes and therians.

    PubMed

    Rich, Thomas H; Hopson, James A; Musser, Anne M; Flannery, Timothy F; Vickers-Rich, Patricia

    2005-02-11

    A dentary of the oldest known monotreme, the Early Cretaceous Teinolophos trusleri, has an internal mandibular trough, which in outgroups to mammals houses accessory jaw bones, and probable contact facets for angular, coronoid, and splenial bones. Certain of these accessory bones were detached from the mandible to become middle ear bones in mammals. Evidence that the angular (homologous with the mammalian ectotympanic) and the articular and prearticular (homologous with the mammalian malleus) bones retained attachment to the lower jaw in a basal monotreme indicates that the definitive mammalian middle ear evolved independently in living monotremes and therians (marsupials and placentals).

  4. Primary T-cell lymphoblastic lymphoma in the middle ear.

    PubMed

    Li, Bo; Liu, Shixi; Yang, Hui; Wang, Weiya

    2016-03-01

    T-cell lymphoblastic lymphoma (T-LBL) is a highly aggressive lymphoma characterized by precursor T-cell malignancy and lymphadenopathy or mediastinal involvement. We present the case of an 11-year-old boy with a diagnosis of middle ear T-LBL, which manifested as a headache, hearing loss and peripheral facial paralysis. The child was given intensive chemotherapy and had a complete response. To our knowledge, this is the first case reported in the literature of T-LBL originating in the middle ear. This case aims to help clinicians to be vigilant about the possibility of primary lesions at atypical sites in some special diseases.

  5. [The reactions of human middle ear mucous membrane (author's transl)].

    PubMed

    Arnold, W

    1977-04-20

    Healthy middle ear mucous membrane of newborns differs from the respiratory mucous membrane of the respiratory tract, in that it lacks a mucociliary epithelial pattern and because it has an absence of cells responsible for immunological resistance. Irritations over a short period of time and intensity cause a mucous membrane edema, which leaves behind, when the irritation disappeares, no permanent morphological changes in the structure of the mucous membrane. Severe irritations over a long period of time cause a characteristic change in the epithelium and submucosa: the single layered flat epithelium is replaced by respiratory epithelium; in the submucosa a proliferation of the connective tissue occurs simultaneously with the development of a local immunologically potent, cellular defense system. The actively secretive epithelial cells serve as the means whereby the antibodies are transported to the surface of the mucous membrane. Whereas at the time of mucous membrane edema, serum components (transsudate) are the primary source of the resulting "serotympanum", an increase in viscosity of the mucous allows one to recognize the active secretive work of the metaplastic epithelium. The biochemical composition of the various effusions givens a direct a direct indication of their origin: it is, however, no key to the cause! Only in the case of purulent secretions is it possible to recognize the cause by cellular or bacteriological identification. The same is valid for the norphological changes of the middle ear mucous membrane since the membrane will generally react in a similar manner, even though the types of irritation differ. When the stimulus which brought about the proliferation of the mucous membrane since the membrane will generally react in a similar manner, even though the types of irritation differ. When the stimulus which brought about the proliferation of the mucous membrane and the epithelial metaplasy disappears, the active production of mucous stops

  6. Microendoscopy of the eustachian tube and the middle ear

    NASA Astrophysics Data System (ADS)

    Hopf, Juergen U. G.; Linnarz, Marietta; Gundlach, Peter; Scherer, Hans H.; Lutze-Koffroth, C.; Loerke, S.; Voege, Karl H.; Tschepe, Johannes; Mueller, Gerhard J.

    1992-08-01

    Progressive miniaturization of flexible fiberoptic instruments has made it possible to perform atraumatic endoscopy of the Eustachian tube and tympanic cavity with an intact ear drum. By means of a special set of carrier- and balloon-catheters which are partly actively steerable, flexible microendoscopes with outside diameters of 290 - 700 micrometers are inserted through the nasal cavity into the nasopharyngeal opening of the Eustachian tube and carefully advanced into the middle ear compartment under permanent direct visual control. Second generation microendoscopes with outside diameters of 750 to 1000 micrometers are equipped with a one- direction tip-steering mechanism which allows deflection up to 90 degrees. In addition to it, the use of two special types of four-function scopes (outside diameter: 1.6 mm and 1.8 mm) fitted with a one-lumen working channel are presented. This new technique of `Transnasal Tubo-Tympanoscopy' (TTT) only needs local anesthesia, normally is performed on an outpatient basis, and is indicated for the diagnosis of any disturbances of the sound conducting apparatus (ear drum and ossicular chain) like chronic otitis media and oto-sclerosis and of those sensorineural hearing disorders on which -- until today -- only the traditional surgical tympanoscopy could provide morphological information on the pathogenesis of the hearing loss, e.g., on assumed round window ruptures. By this minimal invasive and minimal traumatizing method pathological alterations of the ossicular chain as well as obstructions in the cartilaginous and the osseous part of the Eustachian tube can be directly visualized.

  7. Effects of ear-canal pressurization on middle-ear bone- and air-conduction responses

    PubMed Central

    Homma, Kenji; Shimizu, Yoshitaka; Kim, Namkeun; Du, Yu; Puria, Sunil

    2014-01-01

    In extremely loud noise environments, it is important to not only protect one’s hearing against noise transmitted through the air-conduction (AC) pathway, but also through the bone-conduction (BC) pathways. Much of the energy transmitted through the BC pathways is concentrated in the mid-frequency range around 1.5–2 kHz, which is likely due to the structural resonance of the middle ear. One potential approach for mitigating this mid-frequency BC noise transmission is to introduce a positive or negative static pressure in the ear canal, which is known to reduce BC as well as AC hearing sensitivity. In the present study, middle-ear ossicular velocities at the umbo and stapes were measured using human cadaver temporal bones in response to both BC and AC excitations, while static air pressures of ±400 mm H2O were applied in the ear canal. For the maximum negative pressure of −400 mm H2O, mean BC stapes-velocity reductions of about 5–8 dB were observed in the frequency range from 0.8 to 2.5 kHz, with a peak reduction of 8.6(± 4.7) dB at 1.6 kHz. Finite-element analysis indicates that the peak BC-response reduction tends to be in the mid-frequency range because the middle-ear BC resonance, which is typically around 1.5–2 kHz, is suppressed by the pressure-induced stiffening of the middle-ear structure. The measured data also show that the BC responses are reduced more for negative static pressures than for positive static pressures. This may be attributable to a difference in the distribution of the stiffening among the middle-ear components depending on the polarity of the static pressure. The characteristics of the BC-response reductions are found to be largely consistent with the available psychoacoustic data, and are therefore indicative of the relative importance of the middle-ear mechanism in BC hearing. PMID:19944139

  8. Middle Ear Disorders and Hearing Loss in Native Hawaiian Preschoolers.

    ERIC Educational Resources Information Center

    Pang-Ching, Glenn; And Others

    1995-01-01

    Native Hawaiian preschoolers (n=172) received a battery of tests that included pure-tone audiometry, tympanometry, acoustic reflectometry, and pneumatic otoscopy. Approximately 15% of children failed a majority of the tests. Results are discussed in comparison to other indigenous groups at risk for middle ear disorders and hearing loss.…

  9. Acoustic Reflectometry versus Tympanometry in Pediatric Middle Ear Screenings.

    ERIC Educational Resources Information Center

    Holmes, Alice E.; And Others

    1989-01-01

    Use of acoustic reflectometry was compared with tympanometry in middle ear screenings for 357 children, aged 5 months to 19 years. Results were analyzed according to sex, age, and sensorineural hearing status. Intratest reliability was highly significant and positive predictive accuracy and specificity rates were excellent, but sensitivity rates…

  10. Early Middle Ear Effusion and Language at Age Seven

    ERIC Educational Resources Information Center

    Johnson, Dale L.; McCormick, David P.; Baldwin, Constance D.

    2008-01-01

    This study examined the relation of middle ear effusion (MEE) in the first 3 years of life to language outcomes at age seven. It was hypothesized, on the basis of a literature review, that (1) a low, but positive relation between early MEE and language measures in general will be observed at age seven, and (2) major effects will be demonstrated…

  11. Acute effects of sulfur dioxide exposure on the middle ear mucosa

    SciTech Connect

    Ohashi, Y.; Nakai, Y.; Ikeoka, H.; Koshimo, H.; Esaki, Y.

    1989-04-01

    A variety of atmospheric pollutants are known to depress mucociliary function in the respiratory system. Since the mucociliary function in the middle ear is similar, and the middle ear may be invaded by atmospheric pollutants, we decided to investigate the possible contribution of sulfur dioxide to middle ear effusion. Guinea pigs were exposed for 24 hours to 300 ppm of sulfur dioxide or air. Immediately after exposure, ciliary activity and epithelial structure were examined close to the tympanic orifice (proximal site) and more distal to it (distal site). In the animals exposed to sulfur dioxide, no effusion was found in the tympanic cavity. Ciliary activity was reduced only in the distal site. Electron microscopy demonstrated hypersecretion in the proximal site and severe pathologic changes in the distal site. Although the normally functioning cilia in the proximal site may prevent retention of surplus secretions in the ear, sulfur dioxide may promote middle ear effusion when combined with other detrimental factors, because it stimulates mucus secretion in the proximal site and impairs ciliary function in the distal site.

  12. Effect of the middle ear reflex on sound transmission to the inner ear of rat.

    PubMed

    Pilz, P K; Ostwald, J; Kreiter, A; Schnitzler, H U

    1997-03-01

    The effect of the acoustic middle ear reflex (MER) was quantified using electrodes chronically implanted in the middle ears of rats. Cochlear microphonics (CM) and middle ear muscle EMG were measured under light Ketamin anesthesia after stimulation with tone pulses of 5-20 kHz ranging between 75 and 120 dB SPL. With increasing intensity, the CM measured before the onset of the MER increased to a maximum amplitude and then decreased with higher SPLs. At 10 kHz this maximum was reached at 95 dB SPL, for other stimulus frequencies at higher SPLs. After a latency of 10-20 ms, CM to 10 kHz stimuli of 80-95 dB SPL were decreased by the attenuating action of the MER. The lowest threshold of the MER was also measured at 10 kHz (77 dB SPL in the mean). To stimuli greater than 100 dB SPL after a latency of 6-10 ms, the CM amplitude was increased. That this CM increase to intense stimuli is caused by the action of the MER was confirmed by control experiments such as cutting the tendons of the middle ear muscles. The CM decrease to stimuli below 100 dB SPL, as well as the increase to very intense stimuli, can be explained by sound attenuation caused by the MER, together with the nonlinear dependence of CM amplitude on stimulus level. The observed shift of the maxima of the CM input-output function by the MER to higher stimulus levels probably indicates an increase of the dynamic range of the ear.

  13. Poor oral hygiene and middle ear infections: any relationship?

    PubMed

    Esra, Eryaman; Banu, Oter Ilhan; Erdinc, Aydin

    2013-04-01

    The purpose of this study is to evaluate the relationship between poor oral hygiene and middle ear infections. 59 children between 3-12 age intervals were included in this study. The ears were examined by microscope. The findings were marked according to Kempthorne clinical scale and tympanograms were performed. For data analysis of dental caries, dft and DMFT indexes were used in accordance with WHO (World Health Organization) criteria for oral health surveys. The oral hygiene status was determined by using Simplified Oral Hygiene Index of Greene and Vermillion. The scores of 0-1 were classified as low, and of 2-3 as high oral hygiene index (OHI-S). The low OHI-S was taken as the control group (30 patients). The high OHI-S was taken as the study group (29 patients). The effusion scores, the compliance values and the middle ear pressure values in the two groups were compared. The difference between the effusion score values of the control and study groups was found to be statistically meaningful (p = 0.338, and the χ(2) = 2.167). The compliance values of the control and study groups did not differ meaningfully statistically (p = 0.671). However, there was a statistically meaningful low middle ear pressure (p = 0.044, χ(2) = 4.069) in the control group. Since this finding is expected in the study group, instead of the control group, we did not make an issue of this result. We conclude from these clinical results that there is no statistically meaningful relation between the oral hygiene index and the middle ear.

  14. Using the shortwave infrared to image middle ear pathologies.

    PubMed

    Carr, Jessica A; Valdez, Tulio A; Bruns, Oliver T; Bawendi, Moungi G

    2016-09-01

    Visualizing structures deep inside opaque biological tissues is one of the central challenges in biomedical imaging. Optical imaging with visible light provides high resolution and sensitivity; however, scattering and absorption of light by tissue limits the imaging depth to superficial features. Imaging with shortwave infrared light (SWIR, 1-2 μm) shares many advantages of visible imaging, but light scattering in tissue is reduced, providing sufficient optical penetration depth to noninvasively interrogate subsurface tissue features. However, the clinical potential of this approach has been largely unexplored because suitable detectors, until recently, have been either unavailable or cost prohibitive. Here, taking advantage of newly available detector technology, we demonstrate the potential of SWIR light to improve diagnostics through the development of a medical otoscope for determining middle ear pathologies. We show that SWIR otoscopy has the potential to provide valuable diagnostic information complementary to that provided by visible pneumotoscopy. We show that in healthy adult human ears, deeper tissue penetration of SWIR light allows better visualization of middle ear structures through the tympanic membrane, including the ossicular chain, promontory, round window niche, and chorda tympani. In addition, we investigate the potential for detection of middle ear fluid, which has significant implications for diagnosing otitis media, the overdiagnosis of which is a primary factor in increased antibiotic resistance. Middle ear fluid shows strong light absorption between 1,400 and 1,550 nm, enabling straightforward fluid detection in a model using the SWIR otoscope. Moreover, our device is easily translatable to the clinic, as the ergonomics, visual output, and operation are similar to a conventional otoscope. PMID:27551085

  15. Middle-ear microsurgery simulation to improve new robotic procedures.

    PubMed

    Kazmitcheff, Guillaume; Nguyen, Yann; Miroir, Mathieu; Péan, Fabien; Ferrary, Evelyne; Cotin, Stéphane; Sterkers, Olivier; Duriez, Christian

    2014-01-01

    Otological microsurgery is delicate and requires high dexterity in bad ergonomic conditions. To assist surgeons in these indications, a teleoperated system, called RobOtol, is developed. This robot enhances gesture accuracy and handiness and allows exploration of new procedures for middle ear surgery. To plan new procedures that exploit the capacities given by the robot, a surgical simulator is developed. The simulation reproduces with high fidelity the behavior of the anatomical structures and can also be used as a training tool for an easier control of the robot for surgeons. In the paper, we introduce the middle ear surgical simulation and then we perform virtually two challenging procedures with the robot. We show how interactive simulation can assist in analyzing the benefits of robotics in the case of complex manipulations or ergonomics studies and allow the development of innovative surgical procedures. New robot-based microsurgical procedures are investigated. The improvement offered by RobOtol is also evaluated and discussed.

  16. [Clinical experience with silastic middle-ear prostheses].

    PubMed

    Zelený, M; Voldrich, Z

    1989-01-01

    The authors made clinical tests of silastic prostheses of the middle ear, type PORP, TORP and piston. They used 29 X PORP, 26 X TORP and 21 pistons. They did not reveal any signs of tissue intolerance to Silastic MDX 44-516, which is used for making prostheses. They achieved satisfactory anatomical and functional results. They recorded an auditory gain in more than half the patients (early: PORP 97%, TORP 73%, piston 52%; plasty transplants of ossicles obtained from subjects who died accidentallyĕ For preserfic Council of the Ministry of Health, Czech Socialist Republic, recommended, based on the clinical tests, the manufacture of silastic prostheses of the middle ear. PMID:2540918

  17. Rheologic studies on middle ear effusions and their mucus glycoproteins.

    PubMed

    FitzGerald, J E; Green, G G; Birchall, J P; Pearson, J P

    1989-04-01

    The properties of pooled thick and thin middle ear effusions, from children with otitis media with effusion, were studied by viscometry. Mucus glycoproteins were responsible for effusion viscosity. Their percentage by weight in thick and thin effusions was 25% and 8.2%, respectively. N-acetylcysteine and 0.2 mol/L of mercaptoethanol caused a 39% viscosity drop in a 5-mg/mL glycoprotein solution, whereas S-carboxymethylcysteine had no effect. Treatment of thick effusions with 0.2 mol/L of mercaptoethanol initially caused a viscosity decrease followed by a gradual increase. Higher reducing agent concentrations (0.5 mol/L) caused a more rapid decrease followed by a rapid increase, presumably by causing nonspecific aggregation of reduced protein molecules. These results suggest that the concentration of and the time that a mucolytic is in the middle ear would be of prime importance in achieving the desired decrease in viscosity.

  18. Parental smoking and middle ear effusions in children.

    PubMed

    Hinton, A E; Buckley, G

    1988-11-01

    A study was conducted on seventy children to ascertain any relationship between parental smoking and the presence of middle ear effusions in the children. Information was collected using a questionnaire, clinical examination and audiological tests. Both groups of children (with and without effusions) had similar age, sex and social class distributions. It was found that the presence of middle ear effusions in the children was associated with an increased incidence of parental smoking. Those children with an abnormal tympanometry result were more likely to have at least one parent who smoked than those with normal tympanometry results. There was no relationship between resolution of the effusion and parental smoking. It is therefore suggested that as part of the management of this condition parents should be advised of the effects of smoking on the condition and encouraged to avoid smoking in the same environment as their children.

  19. Surgical anatomy and pathology of the middle ear.

    PubMed

    Luers, Jan Christoffer; Hüttenbrink, Karl-Bernd

    2016-02-01

    Middle ear surgery is strongly influenced by anatomical and functional characteristics of the middle ear. The complex anatomy means a challenge for the otosurgeon who moves between preservation or improvement of highly important functions (hearing, balance, facial motion) and eradication of diseases. Of these, perforations of the tympanic membrane, chronic otitis media, tympanosclerosis and cholesteatoma are encountered most often in clinical practice. Modern techniques for reconstruction of the ossicular chain aim for best possible hearing improvement using delicate alloplastic titanium prostheses, but a number of prosthesis-unrelated factors work against this intent. Surgery is always individualized to the case and there is no one-fits-all strategy. Above all, both middle ear diseases and surgery can be associated with a number of complications; the most important ones being hearing deterioration or deafness, dizziness, facial palsy and life-threatening intracranial complications. To minimize risks, a solid knowledge of and respect for neurootologic structures is essential for an otosurgeon who must train him- or herself intensively on temporal bones before performing surgery on a patient.

  20. Passage of albumin from the middle ear to the inner ear in otitis media in the chinchilla

    SciTech Connect

    Goldberg, B.; Goycoolea, M.V.; Schleivert, P.M.; Shea, D.; Schachern, P.; Paparella, M.M.; Carpenter, A.M.

    1981-08-01

    A study of the permeability of the middle ear-inner ear interface for macromolecules was carried out in chinchillas with open and obstructed eustachian tubes utilizing tritiated human serum albumin and immunoelectrophoresis. Tritiated albumin was placed in the round window niche area or normal animals and animals in which the eustachian tubes had been obstructed for 24 hours or 14 days. The tritiated albumin was allowed to remain in the middle ear cavity for 24 hours, Samples of middle ear effusion, perilymph, blood and cerebrospinal fluid were collected and measured for radioactivity. Radioactivity was demonstrated in the perilymph. Samples of middle ear effusions and perilymph were also studied by immunoelectrophoresis with goat antihuman albumin. Albumin placed in the round window niche of an experimental animal could be recovered unchanged in the perilymph. The results suggest a pathophysiologic explanation for the association of otitis media and sensorineural hearing loss or endolymphatic hydrops.

  1. Role of the Mastoid in Middle Ear Pressure Regulation

    PubMed Central

    Alper, Cuneyt M.; Kitsko, Dennis J.; Swarts, J. Douglas; Martin, Brian; Yuksel, Sancak; Doyle, Brendan M. Cullen; Villardo, Richard J. M.; Doyle, William J.

    2011-01-01

    Objective Determine the role of mastoid volume in middle ear pressure (MEP) regulation. The hypothesis was that inert gas exchange between blood and middle ear (ME) is slower for larger mastoid volumes. Study Design Prospective Methods For 21 enrolled subjects, the bilateral surface areas and volumes of the mastoid and tympanum were measured from CT scans in 20 with a wide range of mastoid volumes. Then, 19 subjects were reclined in a chair, fitted with a non-rebreathing mask and breathed room air for 20 minutes (acclimation), a gas composition of 25% N2O, 20% O2, balance N2 for 30 minutes (experiment) and room air for 30 minutes (recovery). Bilateral MEPs were recorded by tympanometry every 2 minutes. The slopes of the MEP-time functions during N20 breathing were calculated to the first observation of Eustachian tube opening and divided by the estimated blood-ME N2O gradient to yield a N2O time-constant. Sufficient data were available for 16 right and 11 left MEs to calculate the time-constant. Results MEP did not change during the baseline period but, within 10 minutes of breathing the N2O mixture, showed a progressive increase. The right-left correlation for the time-constant was 0.87 (n=10 ears, p=0.001). Regression of the time-constants on ME volume showed an inverse relationship (n=23 ears, r=−41, p=0.05). A better data fit was the curvilinear relationship predicted by a mathematical model of the mastoid acting as a ME ear gas reserve. Conclusion These results support the tested hypothesis that the mastoid could serve as ME gas reserve. PMID:21271597

  2. Jun N-Terminal Protein Kinase Enhances Middle Ear Mucosal Proliferation during Bacterial Otitis Media▿

    PubMed Central

    Furukawa, Masayuki; Ebmeyer, Jörg; Pak, Kwang; Austin, Darrell A.; Melhus, Åsa; Webster, Nicholas J. G.; Ryan, Allen F.

    2007-01-01

    Mucosal hyperplasia is a characteristic component of otitis media. The present study investigated the participation of signaling via the Jun N-terminal protein kinase (JNK) mitogen-activated protein kinase in middle ear mucosal hyperplasia in animal models of bacterial otitis media. Otitis media was induced by the inoculation of nontypeable Haemophilus influenzae into the middle ear cavity. Western blotting revealed that phosphorylation of JNK isoforms in the middle ear mucosa preceded but paralleled mucosal hyperplasia in this in vivo rat model. Nuclear JNK phosphorylation was observed in many cells of both the mucosal epithelium and stroma by immunohistochemistry. In an in vitro model of primary rat middle ear mucosal explants, bacterially induced mucosal growth was blocked by the Rac/Cdc42 inhibitor Clostridium difficile toxin B, the mixed-lineage kinase inhibitor CEP11004, and the JNK inhibitor SP600125. Finally, the JNK inhibitor SP600125 significantly inhibited mucosal hyperplasia during in vivo bacterial otitis media in guinea pigs. Inhibition of JNK in vivo resulted in a diminished proliferative response, as shown by a local decrease in proliferating cell nuclear antigen protein expression by immunohistochemistry. We conclude that activation of JNK is a critical pathway for bacterially induced mucosal hyperplasia during otitis media, influencing tissue proliferation. PMID:17325051

  3. [Laser vibrometry. A middle ear and cochlear analyzer for noninvasive studies of middle and inner ear function disorders].

    PubMed

    Rodriguez Jorge, J; Zenner, H P; Hemmert, W; Burkhardt, C; Gummer, A W

    1997-12-01

    A complete battery of audiometric methods is required for the differential diagnosis of different hearing disabilities (including puretone audiometry, impedance, stapes reflex, speech audiometry, brainstam evoked response audiometry, otoacoustic emissions, etc.). In many cases, a comprehensive diagnosis is not possible. Here we describe a new technique based on a laser-Doppler vibrometer that has the potential for non-invasive diagnosis not only middle ear disease but also cochlear pathologies. Disturbance of cochlear function can be ascertained because the input impedance of the cochlea acts as a mechanical load on the middle ear and therefore influences motion of the umbo. In the present study vibration of the umbo and eardrum were measured with a commercially available laser-Doppler vibrometer coupled directly into a standard surgical microscope. The use of the microscope allowed non-invasive measurements of vibrations without having to introduce reflecting material onto the tympanic membrane. Sound pressure was measured with a calibrated probe microphone placed near the tympanic membrane. The displacement response and the specific acoustic impedance of the umbo were calculated from the velocity and sound pressure measured. For normal hearing subjects, the amplitude of the umbo's displacement for frequencies from 0.1 kHz to 1 kHz was 1 nm at 60 dB SPL and decreased with a slope of 6 dB/octave for frequencies between 1 and 5 kHz. A strong correlation was found between the specific acoustic impedance of the umbo and hearing thresholds for hearing-impaired subjects (having otosclerosis or sensorineural hearing losses). The frequency response of the umbo proved to be a means for evaluating the function of both the middle ear and the cochlea under pathological conditions. The measurement technique described is also suitable for intraoperative investigation of the frequency response of the opened middle ear, as well as for the in situ frequency response of partial and

  4. Chinchilla middle-ear admittance and sound power: high-frequency estimates and effects of inner-ear modifications.

    PubMed

    Ravicz, Michael E; Rosowski, John J

    2012-10-01

    The middle-ear input admittance relates sound power into the middle ear (ME) and sound pressure at the tympanic membrane (TM). ME input admittance was measured in the chinchilla ear canal as part of a larger study of sound power transmission through the ME into the inner ear. The middle ear was open, and the inner ear was intact or modified with small sensors inserted into the vestibule near the cochlear base. A simple model of the chinchilla ear canal, based on ear canal sound pressure measurements at two points along the canal and an assumption of plane-wave propagation, enables reliable estimates of Y(TM,) the ME input admittance at the TM, from the admittance measured relatively far from the TM. Y(TM) appears valid at frequencies as high as 17 kHz, a much higher frequency than previously reported. The real part of Y(TM) decreases with frequency above 2 kHz. Effects of the inner-ear sensors (necessary for inner ear power computation) were small and generally limited to frequencies below 3 kHz. Computed power reflectance was ~0.1 below 3.5 kHz, lower than with an intact ME below 2.5 kHz, and nearly 1 above 16 kHz.

  5. Imaging Finding of Malignant Melanoma of Eustachian Tube with Extension to Middle Ear Cavity: Case Report

    PubMed Central

    Kim, Hong Chul; Jang, Han Won

    2012-01-01

    We report a case of malignant melanoma of Eustachian tube with extension to the middle ear cavity and nasopharynx in a 51-year-old woman who presented with right ear fullness. Computed tomography showed a soft tissue mass in the middle ear cavity and causedthe widening and eroding of the bony eustachian tube. Magnetic resonance imaging showed well enhancing mass in eustachian tube extending nasopharynx to middle ear cavity. A biopsy of the middle ear cavity mass revealed a malignant amelanotic melanoma. PMID:23118582

  6. [Cholesteatoma of the external and middle ear in the childhood].

    PubMed

    Mileshina, N A; Kurbatova, E V

    2015-01-01

    The objective of the present work was to enhance the effectiveness of diagnostics of cholesteatoma of the external and middle ear in the children. The study included 66 patients presenting with chronic suppurative otitis media and one child having cholesteatoma of the external auditory meatus. All the patients were examined with the use of otoendoscopy and CT of the temporal bones. It was shown that the frequent occurrence of acute suppurative otitis media, exudative suppurative otitis media, and adhesive otitis media is the risk factor of the development of cholesteatoma of the external and middle ear in the children. The following CT features of cholesteatoma of the external ear were revealed: the sclerotic or mixed type of the mastoid process, the presence of pathological contents in the epitympanic space, homogeneous character of pathological contents in the antrum, widened aditus, caries of antrum walls, the presence of soft tissues around the auditory ossicles, destruction of the long process of the anval bone, and a soft-tissue structure in the external auditory meatus.

  7. [Interleukin-1-containing cells in cholesteatoma of the middle ear].

    PubMed

    Schilling, V; Bujia, J; Negri, B; Kastenbauer, E

    1992-05-01

    Cholesteatoma of the middle ear and the adjacent temporal bone consists of hyperproliferative keratinizing squamous epithelium in the middle ear cavity, and is capable of destroying the bone. Interleukin-1 (IL-1), an autocrine growth factor for epithelial keratinocytes, is characterized by its capacity to initiate bone absorption. Using immunohistochemical methods, the distribution of two different species of interleukin, IL-1 alpha and IL-1 beta, in cholesteatoma tissue (Fig. 2), the skin of the external ear canal, and the retroauricular region was investigated (Fig. 1). Comparable amounts of both IL-1-species were found in all squamous epithelia examined, but interleukin in cholesteatoma epithelium was increased in comparison with normal epidermis. All cellular layers stained uniformly and equally strongly for IL-1 alpha and IL-1 beta, whereas the dead cells of the keratin layer were negative for both. Some intensely stained cells were found scattered in the connective tissue underlying the basal layer of the cholesteatoma (Fig 4). Using double staining techniques these cells were shown to be mainly macrophages (Fig 6). Our results suggest that IL-1 could be liberated from disintegrating keratinocytes and cells of the monocyte-/macrophage lineage, and stimulate the proliferation of the cholesteatoma epithelium in an autocrine manner, thus contributing to the increased bone destruction seen in cholesteatoma.

  8. Ossicular motion related to middle ear transmission delay in gerbil.

    PubMed

    de La Rochefoucauld, Ombeline; Kachroo, Puja; Olson, Elizabeth S

    2010-12-01

    The middle ear transmits sound efficiently from the air in the ear canal (EC) to the fluid filled cochlea. In gerbil, middle ear transmission produces a constant pressure gain between the EC and the cochlea of ∼25 dB from 2 to 40 kHz, and a delay-like phase corresponding to a ∼25-30 μs delay. The mechanisms by which the air-born signal is collected and delivered to the cochlea are not thoroughly understood, and the source of the delay is controversial. We investigated these issues by observing ossicular motion along a single line of sight, roughly parallel to the EC and perpendicular to the stapes footplate. Measurements were made at the umbo, the long process of the manubrium, across the malleus-incus joint, at the long process of the incus, and the stapes head. While the overall delay between EC pressure and stapes velocity was fairly constant with frequency, subcomponents of the delay were frequency dependent. Up to ∼17 kHz, most of the overall delay was between the EC and umbo with a much smaller contribution along the ossicles, whereas in the range from ∼17 to 30 kHz, more of the overall delay was along the ossicles.

  9. Application of a finite element model in the diagnosis process of middle ear pathologies.

    PubMed

    Marin, Karina Cristina; Berdich-Kun, Karla Noemy; Gentil, Fernanda; Parente, Marco; Natal, Renato Jorge; Marin, Horia Alin; Poenaru, Marioara; Popa, Daniela Roxana

    2014-01-01

    The ear is a complex organ that can be affected by various pathologies that are still fairly misunderstood. This work tests the possibilities of studying the ear and its pathologies using a virtual environment and thus bypassing expensive and time-consuming clinical trial. A previous validated finite element model of the middle ear was employed to study two pathological states of the middle ear. It was shown that the model obtained results very close to the clinical evaluation thus proving of being a proper tool for further investigations of middle ear pathologies.

  10. Phonemic Awareness and Middle-Ear Disease among Bedouin Arabs in Israel.

    ERIC Educational Resources Information Center

    Abu-Rabia, Salim

    2002-01-01

    Investigates the effect of middle-ear infections on phonemic awareness on first-grade Bedouin Arab elementary school children in northern Israel. Divides 49 children who were screened according to their infant medical records into two groups: one with repeated middle-ear infection and one without. Indicates a nonsignificant effect of middle-ear…

  11. Middle ear osteoma causing progressive facial nerve weakness: a case report

    PubMed Central

    2014-01-01

    Introduction Facial nerve weakness is most commonly due to Bell’s palsy or cerebrovascular accidents. Rarely, middle ear tumor presents with facial nerve dysfunction. Case presentation We report a very unusual case of middle ear osteoma in a 49-year-old Caucasian woman causing progressive facial nerve deficit. A subtle middle ear lesion was observed on otoscopy and computed tomographic images demonstrated an osseous middle ear tumor. Complete surgical excision resulted in the partial recovery of facial nerve function. Conclusions Facial nerve dysfunction is rarely caused by middle ear tumors. The weakness is typically due to a compressive effect on the middle ear portion of the facial nerve. Early recognition is crucial since removal of these lesions may lead to the recuperation of facial nerve function. PMID:25236378

  12. Update on middle ear barotrauma after hyperbaric oxygen therapy-insights on pathophysiology.

    PubMed

    Lima, Marco Antônio Rios; Farage, Luciano; Cury, Maria Cristina Lancia; Bahamad, Fayez

    2014-04-01

    Introduction Middle ear barotrauma is the most common side effect of hyperbaric oxygen therapy. Knowledge and understanding of its pathophysiology are crucial for an accurate diagnosis and proper decision making about treatment and prevention. Objective Describe up-to-date information on pathophysiology of middle ear barotrauma after hyperbaric oxygen therapy considering the physiology of pressure variation of the middle ear. Data Synthesis Middle ear barotrauma occurs especially during the compression phase of hyperbaric oxygen therapy. The hyperoxic environment in hyperbaric oxygen therapy leads to ventilatory dysfunction of the eustachian tube, especially in monoplace chambers, where the patients are pressurized with 100% O2, favoring middle ear barotrauma. Conclusion The eustachian tube, the tympanic cavity, and mastoid work together in a neural controlled feedback system in which various mechanisms concur for middle ear pressure regulation.

  13. Update on Middle Ear Barotrauma after Hyperbaric Oxygen Therapy—Insights on Pathophysiology

    PubMed Central

    Lima, Marco Antônio Rios; Farage, Luciano; Cury, Maria Cristina Lancia; Bahamad, Fayez

    2014-01-01

    Introduction Middle ear barotrauma is the most common side effect of hyperbaric oxygen therapy. Knowledge and understanding of its pathophysiology are crucial for an accurate diagnosis and proper decision making about treatment and prevention. Objective Describe up-to-date information on pathophysiology of middle ear barotrauma after hyperbaric oxygen therapy considering the physiology of pressure variation of the middle ear. Data Synthesis Middle ear barotrauma occurs especially during the compression phase of hyperbaric oxygen therapy. The hyperoxic environment in hyperbaric oxygen therapy leads to ventilatory dysfunction of the eustachian tube, especially in monoplace chambers, where the patients are pressurized with 100% O2, favoring middle ear barotrauma. Conclusion The eustachian tube, the tympanic cavity, and mastoid work together in a neural controlled feedback system in which various mechanisms concur for middle ear pressure regulation. PMID:25992091

  14. Investigation of middle ear anatomy and function with combined video otoscopy-phase sensitive OCT

    PubMed Central

    Park, Jesung; Cheng, Jeffrey T.; Ferguson, Daniel; Maguluri, Gopi; Chang, Ernest W.; Clancy, Caitlin; Lee, Daniel J.; Iftimia, Nicusor

    2016-01-01

    We report the development of a novel otoscopy probe for assessing middle ear anatomy and function. Video imaging and phase-sensitive optical coherence tomography are combined within the same optical path. A sound stimuli channel is incorporated as well to study middle ear function. Thus, besides visualizing the morphology of the middle ear, the vibration amplitude and frequency of the eardrum and ossicles are retrieved as well. Preliminary testing on cadaveric human temporal bone models has demonstrated the capability of this instrument for retrieving middle ear anatomy with micron scale resolution, as well as the vibration of the tympanic membrane and ossicles with sub-nm resolution. PMID:26977336

  15. Morphometric study of the external and middle ear anatomy in sheep: a possible model for ear experiments.

    PubMed

    Seibel, Valter Alberto Ayres; Lavinsky, Luiz; De Oliveira, José Alfredo Preto

    2006-09-01

    Sheep are a potentially useful model for otologic surgical training and experimentation, currently limited by the scarcity of morphological comparisons between the structure of the ear in sheep and in humans. A detailed morphometric study of the ear in sheep was carried out using computed tomography. Measurements made with AutoCAD Release 14 were compared with measurements for the human ear reported in the literature. In general, ear structures in sheep are two-thirds the size of those in humans. The important anatomical similarities found in this study between the ear in sheep and in humans suggest that sheep may be a useful model for surgical training and experimentation in some middle ear procedures. PMID:16287111

  16. The contribution of selective dysventilation to attical middle ear pathology.

    PubMed

    Marchioni, Daniele; Grammatica, Alberto; Alicandri-Ciufelli, Matteo; Aggazzotti-Cavazza, Elisa; Genovese, Elisabetta; Presutti, Livio

    2011-07-01

    Epitympanic primary cholesteatoma represents a challenge for ENT surgeons. Its exact pathogenesis is still unknown because of the very complex anatomy of this region. Until now, only a few authors have described this region and tried to hypothesize the causes that could lead to cholesteatoma genesis. We hypothesize the existence of a selective dysventilation of the epitympanic region based on the presence of various mucosal folds occluding air ventilation from the middle ear to the epitympanum, through the epitympanic isthmus, causing a negative epitympanic pressure and consequently cholesteatoma formation. All the anatomic findings were obtained with the aid of 0° and 45° angled surgical endoscopes. From our findings, patients affected by an epitympanic cholesteatoma often have a total isthmus blockage that completely isolates the whole epitympanum from the middle ear, causing a deficit of oxygenation of the mucosa that normally should be guaranteed by the Eustachian tube and which always works physiologically in these patients. This is confirmed by the tympanogram test where we observed how the pressure at the level of the tympanic cavity was normal, whereas the epitympanic pressure was selectively negative. In conclusion, selective epitympanic dysventilation syndrome consists of the concomitant presence of a series of complete or incomplete epitympanic diaphragms and ME isthmus blockage causing negative epitympanic pressure, and leading to the formation of a retraction pocket or cholesteatoma associated with normal Eustachian tube function.

  17. Middle-Ear Microsurgery Simulation to Improve New Robotic Procedures

    PubMed Central

    Kazmitcheff, Guillaume; Nguyen, Yann; Miroir, Mathieu; Péan, Fabien; Ferrary, Evelyne; Cotin, Stéphane; Sterkers, Olivier; Duriez, Christian

    2014-01-01

    Otological microsurgery is delicate and requires high dexterity in bad ergonomic conditions. To assist surgeons in these indications, a teleoperated system, called RobOtol, is developed. This robot enhances gesture accuracy and handiness and allows exploration of new procedures for middle ear surgery. To plan new procedures that exploit the capacities given by the robot, a surgical simulator is developed. The simulation reproduces with high fidelity the behavior of the anatomical structures and can also be used as a training tool for an easier control of the robot for surgeons. In the paper, we introduce the middle ear surgical simulation and then we perform virtually two challenging procedures with the robot. We show how interactive simulation can assist in analyzing the benefits of robotics in the case of complex manipulations or ergonomics studies and allow the development of innovative surgical procedures. New robot-based microsurgical procedures are investigated. The improvement offered by RobOtol is also evaluated and discussed. PMID:25157373

  18. Carcinoid tumor of the middle ear: a case report and review of literature

    PubMed Central

    Liu, Guo; Chen, Fei; Li, Jin-Nan; Liu, Shi-Xi

    2014-01-01

    Carcinoid tumors of the middle ear are very rare. Here we describe a 37-year-old man with multiple recurrent carcinoid tumor of the right middle ear. The CT demonstrated the recurrent mass that filled the tympanum and mastoid with osteolytic invasion, and the tumor was removed by surgery. The pathological findings showed the tumor cells, without necrosis and mitotic activity, had round, oval, or slightly irregular nuclei and finely-dispersed chromatin, arranged in cords, nests, and glandular structures. They were strongly positive for synaptophysin and CD56, but were negative for S-100 and chromogranin A. Ki-67 proliferation activity was low (<2%). With a review of the literature, the clinical, pathological characteristics and treatment modalities of this rare tumor are discussed. PMID:25400805

  19. A short-wave infrared otoscope for middle ear disease diagnostics (Conference Presentation)

    NASA Astrophysics Data System (ADS)

    Carr, Jessica A.; Valdez, Tulio; Bruns, Oliver; Bawendi, Moungi

    2016-02-01

    Otitis media, a range of inflammatory conditions of the middle ear, is the second most common illness diagnosed in children. However, the diagnosis can be challenging, particularly in pediatric patients. Otitis media is commonly over-diagnosed and over-treated and has been identified as one of the primary factors in increased antibiotic resistance. We describe the development of a short-wave infrared (SWIR) otoscope for objective middle ear effusion diagnosis. The SWIR otoscope can unambiguously detect the presence of middle ear fluid based on its strong light absorption in the SWIR. This absorption causes a stark, visual contrast between the presence and absence of fluid behind the tympanic membrane. Additionally, when there is no middle ear fluid, the deeper tissue penetration of SWIR light allows the SWIR otoscope to better visualize middle ear anatomy through the tympanic membrane than is possible with visible light. We demonstrate that in healthy, adult human ears, SWIR otoscopy can image a range of middle ear anatomy, including landmarks of the entire ossicular chain, the promontory, the round window niche, and the chorda tympani. We suggest that SWIR otoscopy can provide valuable diagnostic information complementary to that provided by visible pneumotoscopy in the diagnosis of middle ear effusions, otitis media, and other maladies of the middle ear.

  20. Influence of middle ear mucosal condition on post-tympanoplasty audiologic outcome.

    PubMed

    Song, Chan Il; Hong, Hye Ran; Yoon, Tae Hyun

    2016-03-01

    In this study, the association between the middle ear mucosal condition and post-tympanoplasty audiologic outcome was investigated in patients with chronic otitis media without cholesteatoma. One hundred and forty-three patients with chronic otitis media were collected in the Department of Otorhinolaryngology-Head and Neck Surgery at Asan Medical Center between January, 2009 and December, 2011. In the course of tympanoplasty, the status of the middle ear mucosa was divided into normal or abnormal by one surgeon. Pure tone audiometry was performed preoperatively and postoperatively, and post-tympanoplasty tympanogram was also conducted to estimate the condition of middle ear cavity. Of the 143 patients, there were 73 patients with normal middle ear mucosa and 70 patients with abnormal middle ear mucosa around Eustachian tube opening. The mean ABG of subjects with normal middle ear mucosa was 20.1 dB preoperatively, and 9.7 dB postoperatively (p < 0.001). Preoperative mean ABG was 22.4 dB and postoperative mean ABG was 16.4 dB in abnormal middle ear mucosa group (p = 0.137). Postoperative ABGs for 500 and 1000 Hz (7.1, 7.7 dB) in normal middle ear mucosa patients were significantly lower than those (17.2, 19.4 dB) in abnormal middle ear mucosa patients (p < 0.001). There was statistically significant correlation between middle ear mucosa status and post-tympanoplasty audiologic outcomes. The better condition of middle ear ventilation, the better postoperative hearing thresholds revealed after tympanoplasty.

  1. Outer and middle ear status and distortion product otoacoustic emissions in children with sickle cell disease.

    PubMed

    Walker, Letitia J; Stuart, Andrew; Green, Walter B

    2004-12-01

    The purpose of this study was to investigate distortion product otoacoustic emissions (DPOAEs) and outer/middle ear status in 12 African American children with normal hearing and homozygous sickle cell disease (SCD) and age-, gender-, and ear-matched African American controls. C. R. Downs, A. Stuart, & D. Holbert (2000) reported that DPOAE amplitudes were significantly larger for children with SCD. Because the integrity of the middle ear system directly influences OAE characteristics, it was felt that concurrent investigation of DPOAE amplitudes and outer/middle ear function in children with SCD was warranted. DPOAEs were evoked by 13 primary-tone pairs with f2 frequencies ranging from 1000 to 4500 Hz. Outer/middle ear status was assessed with tympanometry through indices of peak compensated static acoustic admittance, tympanometric width, tympanometric peak pressure, ear canal volume, and middle ear resonance frequency. Tympanograms were recorded with probe-tone frequencies of 226 and 678 Hz. DPOAE amplitudes were significantly larger for children with SCD (p < .05). There were no group differences in any of the middle ear indices (p > .05). These findings suggest that increased DPOAE amplitudes for children with SCD cannot be attributed to differences in outer/middle ear function as assessed with tympanometry. PMID:15903142

  2. Effects of Middle Ear Pressure on Otoacoustic Emission Measures.

    NASA Astrophysics Data System (ADS)

    Zhang, Ming

    1995-01-01

    Otoacoustic emissions (OAEs) are used extensively in hearing evaluations. Changes in middle ear pressure may have an effect on both forward and backward transmission of signals through the middle ear. The effect that such changes have on OAEs may depend on extent of pressure change, stimulus frequency, and stimulus level. This study quantitatively evaluates the effects of these variables on distortion product OAEs (DPOAEs) and cochlear microphonic distortion products (CMDPs) for a wide range of stimuli. Pigmented adult guinea pigs were experimental subjects. An animal surgical model was established to manipulate pressure in the middle ear and CMDP and DPOAE were simultaneously measured. The effects on forward transmission were determined from the CMDP data. It was assumed that the DPOAE measures were affected by changes in both forward and backward transmission. The effects on backward transmission were determined from the DPOAE data after the effect on forward transmission were subtracted out. For all conditions the frequency ratio rm f_2/f_1 was held at 1.2 and the level ratio rm L_1/L_2 was 10 dB. The effects on forward transmission were similar to those for backward transmission in all experimental conditions. Negative pressure had a greater effect than positive pressure. Positive pressures of +10 and +20 cmH_2O affected transmission for low frequency stimuli (f_2 = 1620 and 2680 Hz) but had little effect for high frequency stimuli (f_2 = 6980 and 10250 Hz). Negative pressures of -2.5 to -10 cmH_2O affected transmission across all frequencies tested. The effect at low frequencies is hypothesized to be related to tympanic membrane stiffness. The effect of negative pressure at high frequencies may be related to change in the incudostapedial joint. The slope of growth function decreased with the pressure change for DPOAEs but changed little for CMDPs. The decrease in slope for DPOAEs suggests that the level chosen for analysis can influence the result of the

  3. A case of syryngocystadenoma papilliferum (SCAP) involving middle ear, presenting with otomastoiditis and cerebral abscess.

    PubMed

    Presutti, L; Alicandri-Ciufelli, M; Mattioli, F; Marchioni, D; Costantini, M

    2008-09-01

    Syryngocystadenoma papilliferum (SCAP) is an uncommon cutaneous adnexal neoplasm of apocrine gland origin. Until now, fewer than 200 cases have been reported in international literature, of which 12 cases involved the external ear. No cases of SCAP involving the middle ear have been reported. We describe a case of SCAP of external and middle ear, presenting with otomastoiditis and cerebral abscess; this aggressive behavior, never reported for a benign adenoma of the external or middle ear, could lead to a differential diagnosis with cholesteatoma or malignancies.

  4. Spatial Motion in Natural and Reconstructed Middle Ears and the Impact on Sound Transfer

    NASA Astrophysics Data System (ADS)

    Eiber, Albrecht; Heckeler, Christoph; Lauxmann, Michael; Maier, Hannes; Saffarini, Mohammed

    2011-11-01

    During sound transmission the elements of the middle ear carry out frequency dependent motions in all three spatial directions. Particularly the stapes exhibits a piston and rocking motion and recent studies show that rocking also has an impact on hearing. Here the spatial motions of natural and reconstructed ears are considered on the basis of experiments and numerical simulations based on Multibody System (MBS) approach and Finite Element Method (FEM). In case of a passive reconstruction with a PORP the stapes carries out pronounced rocking motions as well as the piston driven by the natural incus in classical stapedotomy. In the active, electromagnetic middle ear implant Phonak Ingenia, a piston prosthesis is driven by the actuator. Due to anatomical restrictions, the axes of the actuator and the prosthesis are not in line and thus a rocking motion of the prosthesis occurs. Compared to passive reconstructions and the natural ear, this rocking is about in the same range of magnitude. In particular, the coupling between actuator and prosthesis is important for the hearing sensation. Thus, a standardized coupling configuration between the Phonak Ingenia actuator and the piston prosthesis with predefined coupling stiffness and damping offers optimal sound transfer.

  5. Middle ear problems in Aboriginal school children cause developmental and educational concerns.

    PubMed

    Thorne, Judith A

    An epidemiological study was carried out in the year 2000 and sought to measure the occurrences of middle ear disease and hearing loss within school aged (4 years to 12 years) Aboriginal children. A number of the local schools and preschools in Coraki and Lismore with a high percentage of Aboriginal students were selected in an effort to identify service gaps regarding essential hearing screenings and assessments. A total of 185 (370 ears) Aboriginal children aged 4 years to 12 years were examined from four schools and three preschools. This examination included otoscopy, tympanometry and audiometry. Data were collected as each child was tested and this was then entered into a computer database on returning to the work place. Results indicated that 61.08% of these children had middle ear problems of some type. Unilateral hearing loss of 30 dB or greater was found in 10.80% of children, bilateral hearing loss of 30 dB and greater was found in 22.16%, and perforation of tympanic membranes in 3.24%. Suggestions are made in relation to the need for ongoing training of Aboriginal Community Audiometrists to provide community, school and preschool screening programs together with health related promotional activities to minimise the occurrences of ear infections.

  6. [The application of ultrasound for diagnostics of middle ear pathologies].

    PubMed

    Kunel'skaia, N L; Garov, E V; Zagorskaia, E E; Sheremet, A S; Baĭbakova, E V; Kudeeva, Ia Iu

    2015-01-01

    The objective of the present work was to summarize the results of the application of ultrasound tests for differential diagnostics of various diseases and lesions affecting the middle ear. Almost 7.000 threshold and suprathreshold studies were carried out in the patients presenting with various forms of sensorineural impairment of hearing. The ultrasound investigations were conducted with the use of the EKHOTEST-02 apparatus (Giperion, Moscow). The results of determination of threshold hearing sensitivity to ultrasound and lateralization of its threshold and suprathreshold values suggest their significance for the detection of even such a minimal disturbance in the cochlear function as the phenomenon of accelerated increase in loudness and the associated enhancement of the severity of the damage to the peripheral sensory system.

  7. MEMS capacitive accelerometer-based middle ear microphone.

    PubMed

    Young, Darrin J; Zurcher, Mark A; Semaan, Maroun; Megerian, Cliff A; Ko, Wen H

    2012-12-01

    The design, implementation, and characterization of a microelectromechanical systems (MEMS) capacitive accelerometer-based middle ear microphone are presented in this paper. The microphone is intended for middle ear hearing aids as well as future fully implantable cochlear prosthesis. Human temporal bones acoustic response characterization results are used to derive the accelerometer design requirements. The prototype accelerometer is fabricated in a commercial silicon-on-insulator (SOI) MEMS process. The sensor occupies a sensing area of 1 mm × 1 mm with a chip area of 2 mm × 2.4 mm and is interfaced with a custom-designed low-noise electronic IC chip over a flexible substrate. The packaged sensor unit occupies an area of 2.5 mm × 6.2 mm with a weight of 25 mg. The sensor unit attached to umbo can detect a sound pressure level (SPL) of 60 dB at 500 Hz, 35 dB at 2 kHz, and 57 dB at 8 kHz. An improved sound detection limit of 34-dB SPL at 150 Hz and 24-dB SPL at 500 Hz can be expected by employing start-of-the-art MEMS fabrication technology, which results in an articulation index of approximately 0.76. Further micro/nanofabrication technology advancement is needed to enhance the microphone sensitivity for improved understanding of normal conversational speech.

  8. Change of middle ear transfer function in otitis media with effusion model of guinea pigs.

    PubMed

    Dai, Chenkai; Gan, Rong Z

    2008-09-01

    Otitis media with effusion (OME) is an inflammatory disease of the middle ear that causes most cases of conductive hearing loss observed in the pediatric population. With the long term goal of evaluating middle ear function with OME, the aim of the current study was to create an animal model of OME in which middle ear transfer functions could be measured. In guinea pigs, OME was created by injecting lipopolysaccharide (LPS) into the middle ear. Evidence of OME was assessed by otoscopy, tympanometry, histology, and by measuring the volume of fluid in the middle ear. Vibrations of the umbo and round window membrane were measured with a laser Doppler vibrometer at frequency range of 200-40 kHz in three groups of 3, 7, and 14 days after injection of LPS. Changes in displacement of the umbo and round window membrane in response to 80 dB SPL sound in the ear canal were measured across the frequency range. Displacement of both the umbo and round window membrane was reduced at all time points following LPS injections. Further, the change of the displacement transmission ratio (DTR) from the tympanic membrane to the round window occurred mainly in chronic (e.g. 14 days post-LPS injection) OME ears. This study provides useful data for analyzing the change of middle ear transfer function in OME ears. PMID:18586077

  9. Structure and function of the mammalian middle ear. II: Inferring function from structure.

    PubMed

    Mason, Matthew J

    2016-02-01

    Anatomists and zoologists who study middle ear morphology are often interested to know what the structure of an ear can reveal about the auditory acuity and hearing range of the animal in question. This paper represents an introduction to middle ear function targetted towards biological scientists with little experience in the field of auditory acoustics. Simple models of impedance matching are first described, based on the familiar concepts of the area and lever ratios of the middle ear. However, using the Mongolian gerbil Meriones unguiculatus as a test case, it is shown that the predictions made by such 'ideal transformer' models are generally not consistent with measurements derived from recent experimental studies. Electrical analogue models represent a better way to understand some of the complex, frequency-dependent responses of the middle ear: these have been used to model the effects of middle ear subcavities, and the possible function of the auditory ossicles as a transmission line. The concepts behind such models are explained here, again aimed at those with little background knowledge. Functional inferences based on middle ear anatomy are more likely to be valid at low frequencies. Acoustic impedance at low frequencies is dominated by compliance; expanded middle ear cavities, found in small desert mammals including gerbils, jerboas and the sengi Macroscelides, are expected to improve low-frequency sound transmission, as long as the ossicular system is not too stiff.

  10. Identification of Actinomyces meyeri actinomycosis in middle ear and mastoid by 16S rRNA analysis.

    PubMed

    Kakuta, Risako; Hidaka, Hiroshi; Yano, Hisakazu; Miyazaki, Hiromitsu; Suzaki, Hiroshi; Nakamura, Yasuhiro; Kanamori, Hajime; Endo, Shiro; Hirakata, Yoichi; Kaku, Mitsuo; Kobayashi, Toshimitsu

    2013-08-01

    Actinomycosis of the middle ear and mastoid is extremely rare. Here, we report a unique case of actinomycosis of the middle ear and mastoid caused by Actinomyces meyeri diagnosed by 16S rRNA gene sequence analysis.

  11. Transmastoid approach to repair meningoencephalic herniation in the middle ear.

    PubMed

    Sergi, B; Passali, G C; Picciotti, P M; De Corso, E; Paludetti, G

    2013-04-01

    Meningoencephalic herniation (MEH) in the middle ear and mastoid is a rare pathological entity with possible life-threatening complications. We treated 24 patients with a trans-mastoid approach, and the bony defect was closed by heterologous materials positioned in a multilayer fashion. The cause of the bony defect were chronic otitis media with cholesteatoma, iatrogenic, spontaneous and post-traumatic. The major presenting symptoms were meningitis, headache, conductive hearing loss, cerebrospinal fluid (CSF leak), neurologic deficit and pneumoencephalus, and stenosis of a canal wall down cavity. During follow-up, no patient developed complications due to surgery or related to the pathology, and imaging showed a stable occlusion of the bony defect. Different surgical treatments have been proposed to repair MEH, and the choice is based on the localization and size of the bony defect, preoperative auditory function and the presence of a coexisting pathology. We propose the use of collagenous membranes and bone substitutes for reconstruction of the floor of the middle fossa.

  12. Magnetically driven middle ear ossicles for optical measurement of vibrations in an ear with opened tympanic membrane.

    PubMed

    Peacock, J; von Unge, M; Dirckx, J

    2013-12-01

    Vibrations of the middle ear ossicles are easily measured by means of laser vibrometry. However, laser vibrometry requires free visual access to the object under investigation, and acquiring free visual access to the ossicles through the ear canal requires the removal of the tympanic membrane (TM), with the result that the ossicles can no longer be stimulated acoustically. To overcome this, we devised a new setup in which the ossicles can be driven magnetically. After measuring the response of the TM to an acoustic signal, we then remove it and attach a small magnet to the exposed manubrium (a part of the most lateral auditory ossicle, the malleus, which is normally attached to the TM). An electromagnetic excitation coil is then used to drive the magnet, and the output to the coil adjusted until the vibration of the manubrium, as measured by the vibrometer, matches that measured in response to the acoustic signal. Such a setup may have uses in research on middle ear mechanics, such as the measurement of nonlinearities in their response, as well as applications in the diagnosis of middle ear conditions such as the fixation of the ossicles by otosclerosis or in chronic otitis media. We describe our setup and discuss the viability of our method and its future clinical potential by presenting some measurements on an artificially fixated ear.

  13. Middle Ear Cavity Morphology Is Consistent with an Aquatic Origin for Testudines

    PubMed Central

    Willis, Katie L.; Christensen-Dalsgaard, Jakob; Ketten, Darlene R.; Carr, Catherine E.

    2013-01-01

    The position of testudines in vertebrate phylogeny is being re-evaluated. At present, testudine morphological and molecular data conflict when reconstructing phylogenetic relationships. Complicating matters, the ecological niche of stem testudines is ambiguous. To understand how turtles have evolved to hear in different environments, we examined middle ear morphology and scaling in most extant families, as well as some extinct species, using 3-dimensional reconstructions from micro magnetic resonance (MR) and submillimeter computed tomography (CT) scans. All families of testudines exhibited a similar shape of the bony structure of the middle ear cavity, with the tympanic disk located on the rostrolateral edge of the cavity. Sea Turtles have additional soft tissue that fills the middle ear cavity to varying degrees. When the middle ear cavity is modeled as an air-filled sphere of the same volume resonating in an underwater sound field, the calculated resonances for the volumes of the middle ear cavities largely fell within testudine hearing ranges. Although there were some differences in morphology, there were no statistically significant differences in the scaling of the volume of the bony middle ear cavity with head size among groups when categorized by phylogeny and ecology. Because the cavity is predicted to resonate underwater within the testudine hearing range, the data support the hypothesis of an aquatic origin for testudines, and function of the middle ear cavity in underwater sound detection. PMID:23342082

  14. [Nasopharyngeal and middle ear flora in children with acute otitis media].

    PubMed

    Zielnik-Jurkiewicz, Beata; Kolczyńska, Magdalena

    2005-01-01

    Nasopharyngeal flora can be a reservoir of bacteria caused acute otitis media in children. The aim of the study was to identify microorganisms and antimicrobial susceptibilities of pathogens from the nasopharynx and middle ear of children with acute otitis media. The study comprised 128 children ages 1 year to 14 years with diagnosed of acute otitis media with purulent discharge. The nasopharyngeal and middle ear samples were collected at the same time. Agar, chocolate, blood and Chapman plates were inoculated for isolation of bacteria. The plates were incubated at 37 degrees C and examined at 24 hours. The susceptibility of bacteria was determined by disk diffusion technique containing concentration gradients for following antibiotics: penicillin, amoxicillin/clavulanate, ampicillin/sulbactam, cefaclor, cefprozil, cefuroxime, erythromycin, azithromycin, clindamycin and trimethoprim/sulfamethoxazole. 196 organisms from nasopharynx and 325 organisms from middle ear were isolated. Most frequent cultured bacteria were: Streptococcus pneumoniae, Haemophilus influenzae and Moraxella catarrhalis--75.6% in nasopharynx and 77.8% in middle ear. We observed statistically significant (p < 0.01) increased of Moraxella catarrhalis in specimens from the middle ear than from nasopharynx. Most of the organisms were susceptible to amoxicillin/clavulanate--83.2% of bacteria from nasopharynx and 81.8% of bacteria from middle ear. Most organisms were resistant to trimethoprim/sulfamethoxazole--60.7% of bacteria from nasopharynx and 62.6% of bacteria from middle ear. Penicillin resistance was observed in 25.0% of bacteria from nasopharynx and 25.6% of bacteria from middle ear. The correlation in resistance of bacteria between trimethoprim/sulfamethoxazole and erythromycin (r = 0.4886) and between trimethoprim/sulfamethoxazole and penicillin (r = 0.5027) was observed. Nasopharyngeal and middle ear flora in children with acute otitis media is similar. In that case susceptibility of

  15. Human middle-ear model with compound eardrum and airway branching in mastoid air cells.

    PubMed

    Keefe, Douglas H

    2015-05-01

    An acoustical/mechanical model of normal adult human middle-ear function is described for forward and reverse transmission. The eardrum model included one component bound along the manubrium and another bound by the tympanic cleft. Eardrum components were coupled by a time-delayed impedance. The acoustics of the middle-ear cleft was represented by an acoustical transmission-line model for the tympanic cavity, aditus, antrum, and mastoid air cell system with variable amounts of excess viscothermal loss. Model parameters were fitted to published measurements of energy reflectance (0.25-13 kHz), equivalent input impedance at the eardrum (0.25-11 kHz), temporal-bone pressure in scala vestibuli and scala tympani (0.1-11 kHz), and reverse middle-ear impedance (0.25-8 kHz). Inner-ear fluid motion included cochlear and physiological third-window pathways. The two-component eardrum with time delay helped fit intracochlear pressure responses. A multi-modal representation of the eardrum and high-frequency modeling of the middle-ear cleft helped fit ear-canal responses. Input reactance at the eardrum was small at high frequencies due to multiple modal resonances. The model predicted the middle-ear efficiency between ear canal and cochlea, and the cochlear pressures at threshold.

  16. Human middle-ear model with compound eardrum and airway branching in mastoid air cells

    PubMed Central

    Keefe, Douglas H.

    2015-01-01

    An acoustical/mechanical model of normal adult human middle-ear function is described for forward and reverse transmission. The eardrum model included one component bound along the manubrium and another bound by the tympanic cleft. Eardrum components were coupled by a time-delayed impedance. The acoustics of the middle-ear cleft was represented by an acoustical transmission-line model for the tympanic cavity, aditus, antrum, and mastoid air cell system with variable amounts of excess viscothermal loss. Model parameters were fitted to published measurements of energy reflectance (0.25–13 kHz), equivalent input impedance at the eardrum (0.25–11 kHz), temporal-bone pressure in scala vestibuli and scala tympani (0.1–11 kHz), and reverse middle-ear impedance (0.25–8 kHz). Inner-ear fluid motion included cochlear and physiological third-window pathways. The two-component eardrum with time delay helped fit intracochlear pressure responses. A multi-modal representation of the eardrum and high-frequency modeling of the middle-ear cleft helped fit ear-canal responses. Input reactance at the eardrum was small at high frequencies due to multiple modal resonances. The model predicted the middle-ear efficiency between ear canal and cochlea, and the cochlear pressures at threshold. PMID:25994701

  17. Middle ear osteoma: a rare cause of conductive hearing loss with normal tympanic membrane.

    PubMed

    Vérillaud, B; Guilleré, L; Williams, M T; El Bakkouri, W; Ayache, D

    2011-01-01

    Osteomas of the temporal bone are benign osseous tumors usually located to the external auditory canal. Osteomas involving the middle ear are very rare. We report the case of a patient presenting with a progressive hearing loss caused by a middle ear osteoma involving the incus and contiguous to the tympanic segment of the facial nerve. This report highlights the value of CT scan in the work-up of conductive or mixed hearing loss with normal tympanic membrane. The management of middle ear osteoma is discussed.

  18. Facial baroparesis secondary to middle-ear over-pressure: a rare complication of scuba diving.

    PubMed

    Hyams, A F; Toynton, S C; Jaramillo, M; Stone, L R; Bryson, P J

    2004-09-01

    A facial nerve palsy, as a result of middle-ear high pressure, is a rare complication of sub-aqua diving. It may occur as a result of an acute pressure change in the middle ear during ascent in those patients who have experienced difficulty equalizing their middle-ear pressure during the prior descent. We present the case history of this occurring in a 21-year-old diver and discuss the pathophysiology, management and the previous literature. The correct diagnosis of this condition is important if unnecessary, and potentially hazardous, recompression treatment is to be avoided.

  19. First Branchial Cleft Fistula Associated with External Auditory Canal Stenosis and Middle Ear Cholesteatoma

    PubMed Central

    Abdollahi fakhim, Shahin; Naderpoor, Masoud; Mousaviagdas, Mehrnoosh

    2014-01-01

    Introduction: First branchial cleft anomalies manifest with duplication of the external auditory canal. Case Report: This report features a rare case of microtia and congenital middle ear and canal cholesteatoma with first branchial fistula. External auditory canal stenosis was complicated by middle ear and external canal cholesteatoma, but branchial fistula, opening in the zygomatic root and a sinus in the helical root, may explain this feature. A canal wall down mastoidectomy with canaloplasty and wide meatoplasty was performed. The branchial cleft was excised through parotidectomy and facial nerve dissection. Conclusion: It should be considered that canal stenosis in such cases can induce cholesteatoma formation in the auditory canal and middle ear. PMID:25320705

  20. Microtomography of the human middle and inner ear

    NASA Astrophysics Data System (ADS)

    Vogel, Uwe; Beckmann, Felix; Zahnert, Thomas; Bonse, Ulrich

    2002-01-01

    Synchrotron radiation and x-ray microtomography based on absorption contrast (performed at HASYLAB at DESY/Hamburg and BAM/Berlin) have been used for imaging of temporal bones and various internal components in situ at spatial resolution down to 7 micrometers with potential enhancement into the submicron range. Due to the volume imaging approach, several hidden structures (e.g., intra-ossicular channels) were revealed. Using several 3D-image processing techniques all data have been segmented into objects (e.g., bony ossicles, ligaments, fluids, air spaces) and subsequently transformed into vectorized data models. Because they are based on the original voxel resolution their content of vector primitives (e.g., polygons) is huge compared to recent models. Therefore they became polygon-reduced to fit into current computation limitations. So far individual data models of the entire hearing apparatus from tympanic membrane to cochlea out of intact specimen, including separate models of ossicles, ligaments and other components have been obtained, provided, in interchangeable data formats (e.g. vector-based: IGES, STL, VRML) and introduced into FEA for modeling of acousto-mechanic transfer characteristics of the middle ear. Their pseudo and real 3D- visualizations (rendering, autosteroscopic display, enlarged solid models) allow easy understanding of the anatomy and pathology of the human hearing organ and may support patient and student education in the field of otology and audiology.

  1. Expression of EGFR and Microvessel Density in Middle Ear Cholesteatoma

    PubMed Central

    Jin, Bong Joon; Min, Hyun Jung; Jeong, Jin Hyeok; Park, Chul Won

    2011-01-01

    Objectives Cholesteatoma destructs bony tissue by the interactions between hyperproliferative epithelial cells and subepithelial inflammatory cells. The aim of this study was to evaluate the expression of epidermal growth factor receptor (EGFR) and microvessel density (MVD) in middle ear cholesteatoma tissue in an effort to determine the relationship between expression of EGFR and neovascularization. Methods We evaluated the expression of EGFR and MVD by immunohistochemical staining for CD31 and Factor VIII in 32 cholesteatoma tissue samples and 7 normal postauricular skin samples. We also analyzed the correlation between EGFR expression and MVD. Results The expression of EGFR was higher in cholesteatoma than in postauricular skin, but the difference was not statistically significant. EGFR was more highly expressed in the suprabasal layer than in the basal layer. Using CD31 and Factor VIII, we analyzed the MVD and found that it was significantly higher in cholesteatoma than in postauricular skin, and significantly correlated with the expression of EGFR. Conclusion Our results suggest that overexpression of EGFR and neovascularization are correlated with the growth of cholesteatoma. PMID:21716952

  2. Electrical middle ear muscle reflex: use in cochlear implant programming.

    PubMed

    Hodges, A V; Balkany, T J; Ruth, R A; Lambert, P R; Dolan-Ash, S; Schloffman, J J

    1997-09-01

    Programming of multichannel cochlear implants (CIs) requires subjective responses to a series of sophisticated psychophysical percepts. It is often difficult for young prelinguistically deaf children to provide adequate responses for device fitting. This is especially true in setting levels of maximum comfortable loudness, whereby failure to indicate growth of loudness may result in elevation of stimulus levels to the threshold of pain. The acoustic or stapedial muscle reflex has been used previously to provide objective confirmation of acoustic stimulation, and there have been attempts to use the reflex in hearing aid fitting. It has also been suggested that electrically elicited middle ear muscle reflexes (eMEMR) may have applicability in confirming and quantifying electrical stimulation through a CI. To assess the relationship between eMEMR characteristics and levels of loudness perception with CIs, determine reliability of the response, and investigate potential use of eMEMR in CI programming, 25 postlinguistically deafened adult CI users were evaluated. Reflexes have also been attempted on 40 children, with responses present in 31 (71%). Comfort levels predicted by eMEMR were highly correlated with those obtained through subjective judgments in the adult subjects. The eMEMR provides an objective, accurate, and rapid method of estimating maximum comfortable loudness levels, which may be useful in the initial programming of young implant recipients.

  3. Mechanical leverage in the middle ear of the American bullfrog, Rana catesbeiana.

    PubMed

    Werner, Yehudah L

    2003-01-01

    Textbooks lump the middle ears of 'submammalian Tetrapoda' as being 'one-ossicle ears'. Conventionally the anuran middle ear is depicted with a shaft-like skeletal unit connecting the tympanic membrane to the inner ear. This shaft comprises mediad a long bony columella and laterad a short cartilaginous extracolumella. But dissection of Rana catesbeiana ears showed: the extracolumella, as long as the columella, is proximally expanded in the vertical plane, forming dorsal and ventral heads. The medio-dorsal head is movably jointed to the columella, between these two there is an obtuse angle ventrad; the extracolumellar medio-ventral head is anchored by a ligament to the middle-ear cavity ceiling. When the tympanic membrane moves outwards, pulling the extracolumella, the medio-dorsal head of the extracolumella must be forced inwards, rotating on the ventral anchorage, pushing the columella towards the inner ear. The ossicular chain thus includes a mechanical lever, possessing the magnitude of the ratio length:width of the extracolumella; this is additional to the lever known from the columellar footplate, which rotates on its firm ventral attachment. These levers are confirmed physiologically, by the difference between the inner-ear sensitivity (shown by isopotential audiograms of microphonic potentials) when stimulated by a vibrator first at the tympanic membrane, then at the proximal stump of the amputated columella. Perusal of the primary literature showed that this morphology is widespread among anuran ears.

  4. Effects of Consecutive Wideband Tympanometry Trials on Energy Absorbance Measures of the Middle Ear

    ERIC Educational Resources Information Center

    Burdiek, Laina M.; Sun, Xiao-Ming

    2014-01-01

    Purpose: Wideband acoustic immittance (WAI) is a new technique for assessing middle ear transfer function. It includes energy absorbance (EA) measures and can be acquired with the ear canal pressure varied, known as "wideband tympanometry" (WBTymp). The authors of this study aimed to investigate effects of consecutive WBTymp testing on…

  5. Middle ear transmission disorders--tympanic membrane vibration analysis by laser-Doppler-vibrometry.

    PubMed

    Stasche, N; Foth, H J; Hörmann, K; Baker, A; Huthoff, C

    1994-01-01

    Laser-Doppler-vibrometry is a useful method to measure vibrations of the tympanic membrane. It is suitable to objectively diagnose the middle ear. In comparison to tympanometry, laser-Doppler-vibrometry has greater sensitivity. Temporal bone specimens were specially prepared to simulate middle ear disorders like middle ear effusion, fixation of the malleus head, fixation of the stapes footplate and removal of the incus. A correlation between the displacement function of the umbo and the experimentally produced middle ear disorders could be demonstrated. For the first time it was possible to measure the vibration of the tympanic membrane by using a laser-Doppler-vibrometer in a healthy 25-year-old male.

  6. Bilateral inverted papilloma of the middle ear with intracranial involvement and malignant transformation: first reported case.

    PubMed

    Dingle, Isaac; Stachiw, Natalka; Bartlett, Anne; Lambert, Paul

    2012-07-01

    Inverted (Schneiderian) papilloma (IP) is a benign but locally aggressive tumor that is typically located in the sinonasal tract. Middle ear involvement and intracranial extension are rare. We present a patient with a history of a completely resected right nasal cavity IP that returned 7 months later with hearing loss, bilateral aural fullness, and right-sided facial weakness. Work-up revealed middle ear IP, and the patient underwent bilateral mastoidectomies. On both sides, the disease caused erosion of the tegmen and was adherent to the underlying dura. There was dehiscence of the carotid canal wall on the left. On the right, the tumor was discovered to have recurred 3 months after initial resection, resulting in complete facial nerve paralysis and trigeminal paresthesias. A right temporal bone resection was undertaken along with neurosurgery. The IP was discovered to have invaded through the dura of the temporal lobe, incase the internal carotid artery, and infiltrate the trigeminal nerve. The facial and vestibulocochlear nerves were sacrificed on the right. Pathology of the right temporal bone revealed malignant transformation to squamous carcinoma. The patient was referred to radiation oncology for postoperative therapy. To our knowledge, this is the first case of bilateral IP of the middle ear with intracranial involvement and malignant transformation. Discussion points include: 1) management of middle ear IP, 2) carotid canal wall dehiscence in erosive middle ear disease, 3) aggressive surgical excision in locally destructive middle ear tumors, and 4) the role of radiation therapy in malignant transformation of IP.

  7. Loudness changes resulting from an electrically induced middle-ear reflex.

    NASA Technical Reports Server (NTRS)

    Gunn, W. J.

    1973-01-01

    An experiment was conducted in order to determine the changes in loudness brought about by electro-cutaneous elicitation of the middle-ear reflex. Subjects were required to judge the relative loudness of the second of three consecutive 30-msec bursts of tone, the second tone being accompanied by an electrical shock to the external auditory meatus, capable of eliciting a contraction of the middle-ear muscles. The difference between these judgments and those of the control condition (shock on the arm) was taken to represent a measure of the attenuation provided by contraction of the middle-ear muscles. Test tones were 500, 1000, 2000, and 3000 Hz at levels of 65, 75, 85, 95, and 105 dB. The results indicate that the middle-ear reflex decreases the middle-ear's transmission mainly for low-frequency sounds. The results fail to lend support to the Loeb-Riopelle hypothesis that the middle-ear reflex acts as a limiter, rather than a linear attenuator.

  8. Schneiderian-Type Papilloma of the Middle Ear: A Review of the Literature.

    PubMed

    Schaefer, Nathan; Chong, Jessica; Griffin, Aaron; Little, Andrew; Gochee, Peter; Dixon, Natalie

    2015-06-01

    Schneiderian-type papilloma of the middle ear is a rare finding. We present a 46-year-old Aboriginal man with a large tympanic membrane perforation and a Schneiderian-type papilloma filling the middle ear. The aim of this study is to familiarize clinicians with this uncommon disease through discussion of its clinical presentation, diagnostic considerations and management. A search of English-language peer-reviewed literature was undertaken using the key words "Schneiderian-type papilloma," "inverted papilloma," and "middle ear." A total of 29 cases (including the present case) of Schneiderian-type papilloma involving the middle ear were reviewed. Common presenting symptoms include hearing loss, otalgia, and otorrhea. Middle ear disease is associated with higher rates of recurrence and malignant transformation than its sinonasal counterpart. Radical surgical resection is the only curative treatment. Schneiderian-type papilloma is a benign, but locally aggressive, epithelial neoplasm most commonly arising in the sinonasal tract. Whilst involvement of the middle ear is extremely rare, knowledge of this condition is important due to its propensity to recur and the high rate of malignant transformation.

  9. Schneiderian-Type Papilloma of the Middle Ear: A Review of the Literature

    PubMed Central

    Schaefer, Nathan; Chong, Jessica; Griffin, Aaron; Little, Andrew; Gochee, Peter; Dixon, Natalie

    2015-01-01

    Schneiderian-type papilloma of the middle ear is a rare finding. We present a 46-year-old Aboriginal man with a large tympanic membrane perforation and a Schneiderian-type papilloma filling the middle ear. The aim of this study is to familiarize clinicians with this uncommon disease through discussion of its clinical presentation, diagnostic considerations and management. A search of English-language peer-reviewed literature was undertaken using the key words “Schneiderian-type papilloma,” “inverted papilloma,” and “middle ear.” A total of 29 cases (including the present case) of Schneiderian-type papilloma involving the middle ear were reviewed. Common presenting symptoms include hearing loss, otalgia, and otorrhea. Middle ear disease is associated with higher rates of recurrence and malignant transformation than its sinonasal counterpart. Radical surgical resection is the only curative treatment. Schneiderian-type papilloma is a benign, but locally aggressive, epithelial neoplasm most commonly arising in the sinonasal tract. Whilst involvement of the middle ear is extremely rare, knowledge of this condition is important due to its propensity to recur and the high rate of malignant transformation. PMID:25564042

  10. a Middle-Ear Reverse Transfer Function Computed from Vibration Measurements of Otoacoustic Emissions on the Ear Drum of the Guinea PIG

    NASA Astrophysics Data System (ADS)

    Dalhoff, Ernst; Turcanu, Diana; Gummer, Anthony W.

    2009-02-01

    Using distortion products measured as vibration of the umbo and as sound pressure in the ear canal of guinea pigs, we calculated the corresponding reverse transfer function. We compare the measurements with a middle-ear model taken from the literature and adapted to the guinea pig. A reasonable fit could be achieved. We conclude that the reverse transfer function will be useful to aid fitting a middle-ear model to measured transfer functions of human subjects.

  11. Optimum dose of radiotherapy for chemodectomas of the middle ear

    SciTech Connect

    Kim, J.A.; Elkon, D.; Lim, M.L.; Constable, W.C.

    1980-07-01

    Forty patients with chemodectomas of the middle ear were seen at the University of Virginia Hospital from 1932 to 1978. Surgery, post-operative radiotherapy or radiotherapy alone were the treatment modalities employed depending on the extent of the disease. These have been reviewed with regard to the clinical presentation and results of treatment with long term follow-up of 1 to 30 years. An attempt was made to determine the optimum dose of radiotherapy based on our data and reported cases in the literature. The majority of patients complaining of tinnitus, otalgia and pulsation obtained significant if not complete relief of symptoms. Cranial nerve defects, however, ofter persisted after therapy. Tumor was considered to be controlled if there was no increase in its size or progression of symptoms. Tumor control was obtained in eight of 10 early patients but only in two of seven more patients with advanced disease with total resection. Control rate with post-operative radiotherapy after subtotal resection was 85%. Radiotherapy alone was used for inoperable or recurrent tumors and control was obtained in 88% of them. In addition to our data, the radiation dose used in over 200 patients reported in the literature was analyzed. There was only a 2% recurrence rate in patients who received 4000 rad/4 weeks or higher. Twenty-two percent of patients treated with less than 4000 rad developed recurrence. The tendency is to use a lower dose of postoperative treatment and a higher dose for gross inoperable tumors. 4000 rad/4 weeks seems to be adequate for control of postoperative residual disease and no more than 5000 rad/5 weeks are required even for advanced inoperable cases. By keeping the dose below 5000 rad/5 weeks, the incidence of complications such as brain necrosis is greatly decreased.

  12. Cavernous Hemangioma of the External Canal, Tympanic Membrane, and Middle Ear Cleft: A Case Report.

    PubMed

    Odat, Haitham; Al-Qudah, Mohannad; Al-Qudah, Mohammad A

    2016-06-01

    Cavernous hemangioma involving the external canal, tympanic membrane, and middle ear cavity is extremely rare. We present a case of a 45-year-old woman who had progressive right sided decreased hearing, pulsatile tinnitus, and aural fullness of 7 months duration. Microscopic examination, imaging studies, surgical treatment, and histological evaluation are reported. To the best of our knowledge, this is the first case of cavernous hemangioma with simultaneous involvement of the external ear, tympanic membrane, middle ear, and attic reported in English literature. PMID:26304856

  13. The development of the middle ear in neonatal chinchillas II. Two weeks to adulthood.

    PubMed

    Hsu, R W; Margolis, R H; Schachern, P A; Javel, E

    2001-09-01

    Studies of auditory function in the human neonate indicate adult-like hearing sensitivity, mature cochlear function and well-developed responses in the auditory pathway. Paradoxically, measurements of middle ear function are characterized by responses that would be interpreted as abnormal in older subjects. Consequently, there is not an accepted clinical test for middle ear disease in the newborn population. Like human neonates, chinchillas have normal hearing sensitivity at birth, but middle ear function tested by multifrequency tympanometry is abnormal compared to the adult. A previous study from our laboratory indicated that the newborn chinchilla middle ear is free of mesenchyme and other debris. Over the first 2 weeks of life there were no significant changes in tympanic membrane thickness and diameter, tympanic membrane to promontory distance and stapes footplate length. There were small changes in mastoid bulla area and perimeter and in mastoid bulla bone thickness. The most striking difference between the newborn and adult temporal bone was in bone composition, the newborn bone having a less dense, spongy appearance. Impedance characteristics of the newborn chinchilla ear, measured by multifrequency tympanometry, were abnormal relative to adult animals and did not change over the first 2 weeks of life. This investigation is an extension of the previous study, designed to better understand the relationship between middle ear function, hearing sensitivity and the structural changes of the newborn chinchilla middle ear. Twenty animals, aged 2-8 weeks, were studied. Additional adult animals were used as controls. Middle ear function was assessed by a wideband reflectance impedance system. Hearing sensitivity was measured by auditory brainstem response in 2- and 8-week-old animals. Structural characteristics of the temporal bone were analyzed using histopathologic preparations. There was an orderly progression in middle ear impedance and reflectance

  14. Experimental and modeling study of human tympanic membrane motion in the presence of middle ear liquid.

    PubMed

    Zhang, Xiangming; Guan, Xiying; Nakmali, Don; Palan, Vikrant; Pineda, Mario; Gan, Rong Z

    2014-12-01

    Vibration of the tympanic membrane (TM) has been measured at the umbo using laser Doppler vibrometry and analyzed with finite element (FE) models of the human ear. Recently, full-field TM surface motion has been reported using scanning laser Doppler vibrometry, holographic interferometry, and optical coherence tomography. Technologies for imaging human TM motion have the potential to lead to using a dedicated clinical diagnosis tool for identification of middle ear diseases. However, the effect of middle ear fluid (liquid) on TM surface motion is still not clear. In this study, a scanning laser Doppler vibrometer was used to measure the full-field surface motion of the TM from four human temporal bones. TM displacements were measured under normal and disease-mimicking conditions with different middle ear liquid levels over frequencies ranging from 0.2 to 8 kHz. An FE model of the human ear, including the ear canal, middle ear, and spiral cochlea was used to simulate the motion of the TM in normal and disease-mimicking conditions. The results from both experiments and FE model show that a simple deflection shape with one or two major displacement peak regions of the TM in normal ear was observed at low frequencies (1 kHz and below) while complicated ring-like pattern of the deflection shapes appeared at higher frequencies (4 kHz and above). The liquid in middle ear mainly affected TM deflection shapes at the frequencies higher than 1 kHz.

  15. Evolution of the mammalian middle ear and jaw: adaptations and novel structures

    PubMed Central

    Anthwal, Neal; Joshi, Leena; Tucker, Abigail S

    2013-01-01

    Having three ossicles in the middle ear is one of the defining features of mammals. All reptiles and birds have only one middle ear ossicle, the stapes or columella. How these two additional ossicles came to reside and function in the middle ear of mammals has been studied for the last 200 years and represents one of the classic example of how structures can change during evolution to function in new and novel ways. From fossil data, comparative anatomy and developmental biology it is now clear that the two new bones in the mammalian middle ear, the malleus and incus, are homologous to the quadrate and articular, which form the articulation for the upper and lower jaws in non-mammalian jawed vertebrates. The incorporation of the primary jaw joint into the mammalian middle ear was only possible due to the evolution of a new way to articulate the upper and lower jaws, with the formation of the dentary-squamosal joint, or TMJ in humans. The evolution of the three-ossicle ear in mammals is thus intricately connected with the evolution of a novel jaw joint, the two structures evolving together to create the distinctive mammalian skull. PMID:22686855

  16. The Influence of Incudostapedial Joint Separation on the Middle Ear Transfer Function

    PubMed Central

    Rusinek, Rafał; Zadrozniak, Marek; Morshed, Kamal; Warminski, Jerzy

    2014-01-01

    Objectives One of the risks in middle ear surgery is high frequency hearing loss. It is believed that manipulations on the middle ear ossicles with the instruments may cause overstimulation of the inner ear and damage of the hear cells. Controversy arises whether temporary separation of the ossicles has any impact on middle ear transfer function and hearing threshold after surgery. The aim of the study is to evaluate the influence of incudostapedial joint (ISJ) separation on middle ear function in an experimental model. Methods With the use of single point laser Doppler vibrometer (LDV) stapes velocity in the intact chain and after ISJ separation was measured in 5 fresh human cadaver temporal bones. Results In all cases there was a decrease in stapes velocity after ISJ separation. Mead stapes velocity was reduced for 1 dB in 800 Hz to 9 dB in frequencies above 1,000 Hz. The decrease of velocity was greater in higher frequencies. Conclusion Separation of the ISJ does not reduce significantly the middle ear function. PMID:25436041

  17. An experimental model for measuring middle ear antimicrobial drug penetration in otitis media.

    PubMed

    Jossart, G H; Erdmann, G R; Levitt, D G; Kucera, P; Le, C T; Juhn, S K; Giebink, G S; Canafax, D M

    1990-12-01

    Bacteria are an important cause of acute otitis media and successful treatment depends on achieving inhibitory or bacteriacidal antimicrobial drug concentrations in the middle ear. To evaluate further otitis media treatment success and failure, we developed a chinchilla model to study antimicrobial drug penetration through the middle ear mucosa. Using quantitative histomorphometry, we measured the middle ear space in 10 chinchillas and found a mean +/- SD volume of 2.09 +/- 0.08 ml and a mean +/- SD surface area of 14.41 +/- 1.48 cm2. To measure the apparent rate constant (Kc) of antibiotic elimination from the middle ear, through the middle ear mucosa, an antibiotic solution was inoculated into the middle ear cavity, and samples were aspirated between 1 and 8 hr later. In normal ears, the mean Kc +/- SD for amoxicillin was 0.118 +/- 0.013 hr-1, that for a trimethoprim 0.461 +/- 0.090 hr-1, and that for sulfamethoxazole 0.265 +/- 0.062 hr-1. In ears inoculated with type 7F Streptococcus pneumoniae to induce acute otitis media, the Kc +/- SD increased for all three drugs (P less than 0.05): amoxicilin to 0.286 +/- 0.089 hr-1, trimethoprim to 0.662 +/- 0.118 hr-1, and sulfamethoxazole to 0.411 +/- 0.056 hr-1. These values demonstrate that amoxicillin had the lowest apparent penetration rate constant of the three antibiotics but the greatest increase from normal to infected mucosa (142%). Trimethoprim had the highest apparent penetration rate constant of the three antibiotics but the smallest increase from normal to infected mucosa (44%), while the sulfamethoxazone apparent penetration rate constant increased from normal to infected mucosa by 55%.(ABSTRACT TRUNCATED AT 250 WORDS)

  18. FGF23 deficiency leads to mixed hearing loss and middle ear malformation in mice.

    PubMed

    Lysaght, Andrew C; Yuan, Quan; Fan, Yi; Kalwani, Neil; Caruso, Paul; Cunnane, MaryBeth; Lanske, Beate; Stanković, Konstantina M

    2014-01-01

    Fibroblast growth factor 23 (FGF23) is a circulating hormone important in phosphate homeostasis. Abnormal serum levels of FGF23 result in systemic pathologies in humans and mice, including renal phosphate wasting diseases and hyperphosphatemia. We sought to uncover the role FGF23 plays in the auditory system due to shared molecular mechanisms and genetic pathways between ear and kidney development, the critical roles multiple FGFs play in auditory development and the known hearing phenotype in mice deficient in klotho (KL), a critical co-factor for FGF23 signaling. Using functional assessments of hearing, we demonstrate that Fgf[Formula: see text] mice are profoundly deaf. Fgf[Formula: see text] mice have moderate hearing loss above 20 kHz, consistent with mixed conductive and sensorineural pathology of both middle and inner ear origin. Histology and high-voltage X-ray computed tomography of Fgf[Formula: see text] mice demonstrate dysplastic bulla and ossicles; Fgf[Formula: see text] mice have near-normal morphology. The cochleae of mutant mice appear nearly normal on gross and microscopic inspection. In wild type mice, FGF23 is ubiquitously expressed throughout the cochlea. Measurements from Fgf[Formula: see text] mice do not match the auditory phenotype of Kl-/- mice, suggesting that loss of FGF23 activity impacts the auditory system via mechanisms at least partially independent of KL. Given the extensive middle ear malformations and the overlap of initiation of FGF23 activity and Eustachian tube development, this work suggests a possible role for FGF23 in otitis media.

  19. Contralateral suppression of distortion product otoacoustic emissions and the middle-ear muscle reflex in human ears.

    PubMed

    Sun, Xiao-Ming

    2008-03-01

    Distortion product otoacoustic emissions (DPOAEs) were measured in the absence and presence of contralateral noise at five levels--below, equal to, and above the middle-ear muscle (MEM) reflex threshold. The resultant changes in DPOAE level and phase were dependent on stimulus frequency and noise level. Both low-level noise, believed to elicit the medial olivocochlear (MOC) reflex, and high-level noise, thought to activate both MOC and MEM reflexes, significantly decreased the DPOAE level. However, the shift from sole MOC effect to mixed MOC and MEM effects was not as dramatic as we thought. While low-level noise resulted in a minimum DPOAE phase change, high-level noise caused a substantial phase lead for 1 and 2kHz. With increasing frequency, phase lag became more notable. The present study suggests the following: (1) DPOAE contralateral suppression by low-level sound most likely does not involve the effect of the MEM reflex and signal crossover; and (2) combined analysis of DPOAE level and phase changes warrants further investigations to overcome the difficulty in separating the effects of MOC efferents and MEM contraction. The results also imply that OAE measurement has the potential for being used to investigate the effect of the MEM reflex on sound transmission. PMID:18258398

  20. Effect of low-intensity focused ultrasound on the middle ear in a mouse model of acute otitis media.

    PubMed

    Noda, Kanako; Hirano, Takashi; Noda, Kenji; Kodama, Satoru; Ichimiya, Issei; Suzuki, Masashi

    2013-03-01

    We hypothesized that low-intensity focused ultrasound (LIFU) increases vessel permeability and antibacterial drug activity in the mouse middle ear. We determined appropriate settings by applying LIFU to mouse ears with the external auditory canal filled with normal saline and performed histologic and immunohistologic examination. Acute otitis media was induced in mice with nontypable Haemophilus influenzae, and they were given ampicillin (50, 10, or 2 mg/kg) intraperitoneally once daily for 3 days with or without LIFU (1.0 W/cm(2), 20% duty cycle, 30 s). In the LIFU(+) groups receiving the 2- and 10-mg/kg doses, viable bacteria counts, number of inflammatory cells and IL-1β and TNF-α levels in middle ear effusion were significantly lower than in the LIFU(-) groups on the same doses. Severity of AOM also tended to be reduced more in the LIFU(+) groups than in the LIFU(-) groups. LIFU application with antibiotics may be effective for middle ear infection. PMID:23312959

  1. Effect of low-intensity focused ultrasound on the middle ear in a mouse model of acute otitis media.

    PubMed

    Noda, Kanako; Hirano, Takashi; Noda, Kenji; Kodama, Satoru; Ichimiya, Issei; Suzuki, Masashi

    2013-03-01

    We hypothesized that low-intensity focused ultrasound (LIFU) increases vessel permeability and antibacterial drug activity in the mouse middle ear. We determined appropriate settings by applying LIFU to mouse ears with the external auditory canal filled with normal saline and performed histologic and immunohistologic examination. Acute otitis media was induced in mice with nontypable Haemophilus influenzae, and they were given ampicillin (50, 10, or 2 mg/kg) intraperitoneally once daily for 3 days with or without LIFU (1.0 W/cm(2), 20% duty cycle, 30 s). In the LIFU(+) groups receiving the 2- and 10-mg/kg doses, viable bacteria counts, number of inflammatory cells and IL-1β and TNF-α levels in middle ear effusion were significantly lower than in the LIFU(-) groups on the same doses. Severity of AOM also tended to be reduced more in the LIFU(+) groups than in the LIFU(-) groups. LIFU application with antibiotics may be effective for middle ear infection.

  2. Presence of viral nucleic acids in the middle ear: acute otitis media pathogen or bystander?

    PubMed

    Chonmaitree, Tasnee; Ruohola, Aino; Hendley, J Owen

    2012-04-01

    Viruses play an important role in acute otitis media (AOM) pathogenesis, and live viruses may cause AOM in the absence of pathogenic bacteria. Detection of AOM pathogens generally relies on bacterial culture of middle ear fluid. When viral culture is used and live viruses are detected in the middle ear fluid of children with AOM, the viruses are generally accepted as AOM pathogens. Because viral culture is not sensitive and does not detect the comprehensive spectrum of respiratory viruses, polymerase chain reaction assays are commonly used to detect viral nucleic acids in the middle ear fluid. Although polymerase chain reaction assays have greatly increased the viral detection rate, new questions arise on the significance of viral nucleic acids detected in the middle ear because nucleic acids of multiple viruses are detected simultaneously, and nucleic acids of specific viruses are detected repeatedly and in a high proportion of asymptomatic children. This article first reviews the role of live viruses in AOM and presents the point-counterpoint arguments on whether viral nucleic acids in the middle ear represent an AOM pathogen or a bystander status. Although there is evidence to support both directions, helpful information for interpretation of the data and future research direction is outlined.

  3. Environmental influences in the evolution of tetrapod hearing sensitivity and middle ear tuning.

    PubMed

    Gridi-Papp, Marcos; Narins, Peter M

    2009-12-01

    Vertebrates inhabit and communicate acoustically in most natural environments. We review the influence of environmental factors on the hearing sensitivity of terrestrial vertebrates, and on the anatomy and mechanics of the middle ears. Evidence suggests that both biotic and abiotic environmental factors affect the evolution of bandwidth and frequency of peak sensitivity of the hearing spectrum. Relevant abiotic factors include medium type, temperature, and noise produced by nonliving sources. Biotic factors include heterospecific, conspecific, or self-produced sounds that animals are selected to recognize, and acoustic interference by sounds that other animals generate. Within each class of tetrapods, the size of the middle ear structures correlates directly to body size and inversely to frequency of peak sensitivity. Adaptation to the underwater medium in cetaceans involved reorganization of the middle ear for novel acoustic pathways, whereas adaptation to subterranean life in several mammals resulted in hypertrophy of the middle ear ossicles to enhance their inertial mass for detection of seismic vibrations. The comparative approach has revealed a number of generalities about the effect of environmental factors on hearing performance and middle ear structure across species. The current taxonomic sampling of the major tetrapod groups is still highly unbalanced and incomplete. Future expansion of the comparative evidence should continue to reveal general patterns and novel mechanisms. PMID:21665852

  4. Multiwavelength Fluorescence Otoscope for Video-Rate Chemical Imaging of Middle Ear Pathology

    PubMed Central

    2015-01-01

    A common motif in otolaryngology is the lack of certainty regarding diagnosis for middle ear conditions, resulting in many patients being overtreated under the worst-case assumption. Although pneumatic otoscopy and adjunctive tests offer additional information, white light otoscopy has been the main tool for diagnosis of external auditory canal and middle ear pathologies for over a century. In middle ear pathologies, the inability to avail high-resolution structural and/or molecular imaging is particularly glaring, leading to a complicated and erratic decision analysis. Here, we propose a novel multiwavelength fluorescence-based video-rate imaging strategy that combines readily available optical elements and software components to create a novel otoscopic device. This modified otoscope enables low-cost, detailed and objective diagnosis of common middle ear pathological conditions. Using the detection of congenital cholesteatoma as a specific example, we demonstrate the feasibility of fluorescence imaging to differentiate this proliferative lesion from uninvolved middle ear tissue based on the characteristic autofluorescence signals. Availability of real-time, wide-field chemical information should enable more complete removal of cholesteatoma, allowing for better hearing preservation and substantially reducing the well-documented risks, costs and psychological effects of repeated surgical procedures. PMID:25226556

  5. Effect of middle ear fluid on sound transmission and auditory brainstem response in guinea pigs.

    PubMed

    Guan, Xiying; Gan, Rong Z

    2011-07-01

    Combined measurements of middle ear transfer function and auditory brainstem response (ABR) in live guinea pigs with middle ear effusion (MEE) are reported in this paper. The MEE model was created by injecting saline into the middle ear cavity. Vibrations of the tympanic membrane (TM), the tip of the incus, and the round window membrane (RWM) were measured with a laser vibrometer at frequencies of 0.2-40 kHz when the middle ear fluid increased from 0 to 0.2 ml (i.e., full fill of the cavity). The click and pure tone ABRs were recorded as the middle ear fluid increased. Fluid introduction reduced mobility of the TM, incus and RWM mainly at high frequencies (f > 1 kHz). The magnitude of this reduction was related to the volume of fluid. The displacement transmission ratio of the TM to incus varied with frequency and fluid level. The volume displacement ratio of the oval window to round window was approximately 1.0 over most frequencies. Elevation of ABR thresholds and prolongation of ABR latencies were observed as fluid level increased. Reduction of TM displacement correlated well with elevation of ABR threshold at 0.5-8 kHz. Alterations in the ratio of ossicular displacements before and after fluid induction are consistent with fluid-induced changes in complex ossicular motions. PMID:21414396

  6. Mucormycosis of the middle ear: a case report with review of literature.

    PubMed

    Hazarika, P; Zachariah, Joyse; Victor, John; John, Molly; Devi, Chitra; Abraham, Prakash

    2012-03-01

    Mucor is a saprophytic organism and commonly invades the nose and paranasal sinuses of immunocompromised and diabetic patients involvement of the middle ear and mastoid in a nondiabetic patients is very rare and this may be the first case report clinical presentation of ear pain with reference to the mastoid and upper neck may be the early symptoms unlike the foul smelling ear discharge as seen in atticoantral disease. Radical debridement in the form of M.R.M with or without the use of amphotericin B may suffice in non-diabetic patients this case is reported to highlight the point that mucormycosis can also involve middle ear and mastoid in nondiabetic patients. PMID:23449740

  7. [Application of the middle ear implant in case of high frequency hearing loss--case study].

    PubMed

    Skarzyński, Henryk; Obrycka, Anita; Piotrowska, Anna; Lorens, Artur

    2008-01-01

    People who suffer from hearing impairment complain mainly of a problem with communication. Wearing hearing aids can often compensate some problems related with moderate to serve sensorineural hearing loss. Many of hearing aids users complain of some problems associated with plugging the ear canal, such as feedback, unpleasant sound while eating, unnatural sound of their own voice, physical discomfort. The alternative method for some group of patients with sensorineural loss is the middle ear implant. In the middle ear implant the sound is converted into mechanical vibrations that directly drive the ossicular chain inside the middle ear. It leaves the ear canal open and ear drum undisturbed. The sound quality is improved and residual hearing is preserved. Additionally feedback is reduced while comfort improved. 53-year-old man with bilateral sensorineural hearing loss (mild at low frequencies up to 1000 Hz in combination with serve degree at high frequencies) was implanted with Vibrant Soundbridge system. Tests of speech comprehension in quiet were performed using monosyllabic word lists. Improvement in patienfs score was observed while testing with Vibrant Soundbridge. Patient also reports significant improvement in subjective assessment. Application of the Floating Mass Transducer for sound processing results in significant improvement in sound quality. Results obtained indicate a high level of benefits with the Yibrant Soundbridge.

  8. Investigation of bacterial biofilm in the human middle ear using optical coherence tomography and acoustic measurements.

    PubMed

    Nguyen, Cac T; Robinson, Sarah R; Jung, Woonggyu; Novak, Michael A; Boppart, Stephen A; Allen, Jont B

    2013-07-01

    Children with chronic otitis media (OM) often have conductive hearing loss which results in communication difficulties and requires surgical treatment. Recent studies have provided clinical evidence that there is a one-to-one correspondence between chronic OM and the presence of a bacterial biofilm behind the tympanic membrane (TM). Here we investigate the acoustic effects of bacterial biofilms, confirmed using optical coherence tomography (OCT), in adult ears. Non-invasive OCT images are collected to visualize the cross-sectional structure of the middle ear, verifying the presence of a biofilm behind the TM. Wideband measurements of acoustic reflectance and impedance (0.2-6 [kHz]) are used to study the acoustic properties of ears with confirmed bacterial biofilms. Compared to known acoustic properties of normal middle ears, each of the ears with a bacterial biofilm has an elevated power reflectance in the 1 to 3 [kHz] range, corresponding to an abnormally small resistance (real part of the impedance). These results provide assistance for the clinical diagnosis of a bacterial biofilm, which could lead to improved treatment of chronic middle ear infection and further understanding of the impact of chronic OM on conductive hearing loss. This article is part of a special issue entitled "MEMRO 2012".

  9. Salivary gland choristoma of the middle ear in a child with situs inversus totalis.

    PubMed

    Toros, Sema Zer; Egeli, Erol; Kiliçarslan, Yasin; Gümrükçü, Gülistan; Gökçeer, Tanju; Noşeri, Hülya

    2010-06-01

    Salivary gland choristoma of the middle ear cavity is an extremely rare entity. It is thought to be a developmental abnormality and may be associated with abnormalities of adjacent structures. We report a case of salivary gland choristoma of the middle ear with prominent Körner's septum in a 7-year-old girl with situs inversus totalis. Situs inversus totalis is the mirror image reversal of the normal position of the internal organs and frequently associated with other congenital anomalies. This patient is the first reported case with situs inversus totalis, having middle ear salivary gland choristoma and prominent bilateral Körner's septae. The management and the differential diagnosis of this condition are discussed with the review of the literature.

  10. Results of endoscopic middle ear surgery for cholesteatoma treatment: a systematic review.

    PubMed

    Presutti, L; Gioacchini, F M; Alicandri-Ciufelli, M; Villari, D; Marchioni, D

    2014-06-01

    Traditional surgery for cholesteatoma of the middle ear is performed by microscopic approaches. However, in recent years endoscopic instrumentation, techniques and knowledge have greatly improved, and in our opinion endoscopic surgical techniques will gain increasing importance in otologic surgery in the future. The aim of this study was to focus on outcomes obtained using endoscopic surgery for the treatment of middle ear cholesteatoma. A systematic review of the literature was performed. A total of 7 articles comprising 515 patients treated exclusively with endoscope or with a combined technique were found. During post-surgical follow-up, 48 (9.3%) patients showed a residual or recurrent pathology. Despite the small number of patients analyzed in our review, the outcomes of this technique appear to be promising. In particular, concerning the rates of recurrences and residual disease, endoscopic middle ear surgery appears to guarantee similar results in comparison to classic microscopic approaches with the advantage of performing minimally invasive surgery.

  11. From conception to application of a tele-operated assistance robot for middle ear surgery.

    PubMed

    Nguyen, Yann; Miroir, Mathieu; Kazmitcheff, Guillaume; Ferrary, Evelyne; Sterkers, Olivier; Grayeli, Alexis Bozorg

    2012-09-01

    The authors' goal was to design and evaluate a robot dedicated to middle ear surgery. Specifications for dimensions, forces, and kinematics were collected, based on the otosclerosis procedure. The robot structure has a compact geometry with 3 linear and 3 rotatory motors. It is remotely piloted via a robot-surgeon interface under operative microscope. Ability to reach anatomical targets, to perform stapedectomy, and to place prosthesis in a model of stapedotomy was evaluated by 6 surgeons. Multiple anatomical targets in the middle ear could be successfully reached without damaging surrounding structures. The robot could be used under operative microscope with minimal visual field impairment or jointly with a 4-mm endoscope through the external auditory canal to perform stapedectomy in temporal bone specimens. Prosthesis could be inserted in the stapedotomy model. The assistance robot is the first prototype with 6 degrees of freedom, a kinematic structure, and dimensions optimized for tele-operated middle ear surgery.

  12. Intrapetrous internal carotid artery aneurysm diagnosed on the basis of middle ear effusion: A case report

    PubMed Central

    WANG, YING; GUAN, BING; TIAN, TONGTONG; PENG, XIN; XU, LI

    2015-01-01

    The present study reports a rare case of a giant intrapetrous internal carotid aneurysm that compressed the internal jugular vein causing recurrent middle ear effusion in a 13-year-old female. Images obtained by computed tomography revealed middle ear effusion occupying the right side of the attic. Digital subtraction angiography (DSA) resulted in a diagnosis of a giant aneurysm of the right intrapetrous carotid artery, with a diameter of 25 mm and a neighboring area of compression of the internal jugular vein. The patient was treated successfully using coil embolization. The present study therefore indicates that DSA should be considered in the differential diagnosis of patients with middle ear effusion. Early treatment with coil embolization or other surgical treatments can be a life-saving therapeutic approach. PMID:26171015

  13. Unusual presentation of glomus tympanicum tumour: New bone formation in the middle ear.

    PubMed

    Kumar, Gaurav; Andreou, Zenon; Virk, Jagdeep Singh; Owa, Anthony

    2014-09-16

    The objective of this study is to increase awareness of the rare presentation, diagnostic difficulties and management of glomus tympanicum of the middle ear. A 49 years old male, with a background of hypertension and epilepsy, presented with a two month history of left sided conductive hearing loss, pulsatile tinnitus and headache. Clinically and radiologically a diagnosis of glomus tympanicum was made. Intraoperatively, extensive osteogenesis of the middle ear resulting in ossicular fixation and erosion was found. This patient required a two stage operation for full clearance of disease. A stapedectomy drill was used to drill off the bony overgrowth surrounding the ossicles resulting in improved hearing thresholds and full clearance of the disease at two year follow up. Glomus tympanicum can result in new bone formation in the middle ear with resultant ossicular fixation and conductive hearing loss. This can be effectively treated surgically with restoration of hearing. PMID:25232551

  14. Unusual presentation of glomus tympanicum tumour: New bone formation in the middle ear

    PubMed Central

    Kumar, Gaurav; Andreou, Zenon; Virk, Jagdeep Singh; Owa, Anthony

    2014-01-01

    The objective of this study is to increase awareness of the rare presentation, diagnostic difficulties and management of glomus tympanicum of the middle ear. A 49 years old male, with a background of hypertension and epilepsy, presented with a two month history of left sided conductive hearing loss, pulsatile tinnitus and headache. Clinically and radiologically a diagnosis of glomus tympanicum was made. Intraoperatively, extensive osteogenesis of the middle ear resulting in ossicular fixation and erosion was found. This patient required a two stage operation for full clearance of disease. A stapedectomy drill was used to drill off the bony overgrowth surrounding the ossicles resulting in improved hearing thresholds and full clearance of the disease at two year follow up. Glomus tympanicum can result in new bone formation in the middle ear with resultant ossicular fixation and conductive hearing loss. This can be effectively treated surgically with restoration of hearing. PMID:25232551

  15. The architecture of the middle ear in the small Indian mongoose (Herpestes Javanicus).

    PubMed

    Kamali, Y; Gholami, S; Ahrari-Khafi, M S; Rasouli, B; Shayegh, H

    2015-01-01

    The small Indian mongoose (Herpestes javanicus) is native to the Middle East, Iran and much of southern Asia. For this study the middle ears of a total of 6 adult small Indian mongooses, both fresh and museum samples were explored by using of dissection and plain radiography. On the one hand, at least in some species of the mongoose vocalisations and hearings play a critical role in coordinating behaviours. On the other hand, the ear region has provided useful character relevant for mammalian phylogeny. So, the aim of the present study is a brief discussion of the various anatomic particularities of the middle ear based on a combination of existing data and the results of the authors' study in the small Indian mongoose. PMID:26339815

  16. Ear Disorders

    MedlinePlus

    ... ear, where they make your eardrum vibrate. The vibrations are transmitted through three tiny bones, called ossicles, in your middle ear. The vibrations travel to your inner ear, a snail-shaped ...

  17. Ear Infections

    MedlinePlus

    MENU Return to Web version Ear Infections Overview How does the ear work? A tube called the eustachian (say: "you-stay-shee-an") tube connects the middle ear with the back of the nose. Normally this ...

  18. Ear barotrauma

    MedlinePlus

    ... Ear popping - barotrauma; Pressure-related ear pain; Eustachian tube dysfunction - barotrauma ... air pressure outside of the body. The Eustachian tube is a connection between the middle ear and ...

  19. Wideband acoustic immittance measurements of the middle ear: introduction and some historical antecedents.

    PubMed

    Lilly, David J; Margolis, Robert H

    2013-07-01

    This supplement focuses on some of the most recent acoustic measurements within the occluded, human external auditory meatus (EAM). The goal of this introduction is to provide an overview of basic and clinical EAM measurements that evolved in the 20th century and some relations between these measurements and wideband acoustic absorbance. The authors review some of the major efforts that have been used to evaluate the condition of the human, adult middle ear transmission system, the middle ear cavity, and the function of the Eustachian tube. They have grouped most of this work under the rubric of “acoustic immittance.” A historical perspective helps one appreciate that the measurement of wideband acoustic absorbance is not a totally new procedure. Rather, it is the latest enhancement to aural acoustic-immittance measurements. An enhancement that can expand one's ability to characterize middle ear function and effects of ear disease on that function. It also allows clinicians evaluate middle ear function for frequencies whose wavelength is shorter than the length of the EAM.

  20. Effects of polylactic acid film on middle ear mucosa and cochlear function in Guinea pigs.

    PubMed

    Ensari, Nuray; Tutar, Hakan; Ekinci, Ozgur; Ugur, Mehmet Birol; Bayazıt, Yıldırım A; Gokdogan, Cagil; Goksu, Nebil

    2015-05-01

    Our aim was to assess the effects of polylactic acid (PLA) on middle ear mucosa and cochlea, to be used as a film barrier for postoperative adhesion prevention in the middle ear. Twenty-one albino Guinea pigs were included in the study. A window was opened on both tympanic bulla and on one side PLA material was placed in the middle ear and on the other side only fenestration was performed and used as a control. All Guinea pigs underwent evaluation of tympanic membranes microscopically; functional hearing was analyzed by auditory brainstem responses preoperatively, in the first and the sixth month. All Guinea pigs were killed on the sixth month for histopathologic evaluation of their temporal bones. There was no statistical difference between both groups regarding hearing thresholds, interpeak wave latencies preoperatively and on first and the sixth months postoperatively. Histopathological evaluation revealed no specific changes. There was a mild local inflammation both in the PLA implanted and control ears. PLA film barrier most likely has no toxic effects on Guinea pig middle ear and does not show any ototoxic side effects.

  1. A prediction of the minke whale (Balaenoptera acutorostrata) middle-ear transfer functiona)

    PubMed Central

    Tubelli, Andrew A.; Zosuls, Aleks; Ketten, Darlene R.; Yamato, Maya; Mountain, David C.

    2012-01-01

    The lack of baleen whale (Cetacea Mysticeti) audiograms impedes the assessment of the impacts of anthropogenic noise on these animals. Estimates of audiograms, which are difficult to obtain behaviorally or electrophysiologically for baleen whales, can be made by simulating the audiogram as a series of components representing the outer, middle, and inner ear (Rosowski, 1991; Ruggero and Temchin, 2002). The middle-ear portion of the system can be represented by the middle-ear transfer function (METF), a measure of the transmission of acoustic energy from the external ear to the cochlea. An anatomically accurate finite element model of the minke whale (Balaenoptera acutorostrata) middle ear was developed to predict the METF for a mysticete species. The elastic moduli of the auditory ossicles were measured by using nanoindentation. Other mechanical properties were estimated from experimental stiffness measurements or from published values. The METF predicted a best frequency range between approximately 30 Hz and 7.5 kHz or between 100 Hz and 25 kHz depending on stimulation location. Parametric analysis found that the most sensitive parameters are the elastic moduli of the glove finger and joints and the Rayleigh damping stiffness coefficient β. The predicted hearing range matches well with the vocalization range. PMID:23145610

  2. In vivo study on middle ear bone ablation with pulse CO2 laser

    NASA Astrophysics Data System (ADS)

    Zhang, Xianzeng; Wang, Xiaoyan; Zhang, Zhenlin; Ye, Qing; Xie, Shusen

    2009-07-01

    To evaluate the feasibility of middle ear bone ablation in-vivo with pulse CO2 laser. Healthy male New Zealand rabbits were used in the experiment. Middle ear mastoid bone of animal model was completely exposed by surgeon with conventional method, and then Pulse CO2 laser with a wavelength of 10.6μm and pulse lengths of about 10ms was used to carry out the opening surgery. Laser fluence was 8.3 J/cm2 with a repetition rates of 60 Hz, the beam diameter was 1.0 mm. After opening surgery, whole middle ear mastoid bone was obtained and processed with traditional histological method, the morphology changes and thermal damage around the opening window were examined by light microscope. Total operation time and light irradiation time were recorded. It showed that pulse CO2 laser is suitable for the fenestration operation in middle ear bone, and this no-touch technique not only can obtain the similar outcome as traditional methods, but also present a lot of advantages compared to the traditional methods. With the development of laser technology and the appearance of relative instruments, especially when the thermal damage was efficiently controlled, fenestration operation in ear with laser systems will be possible in near future.

  3. Biocompatibility of silver containing silica films on Bioverit® II middle ear prostheses in rabbits.

    PubMed

    Duda, Franziska; Bradel, Susanne; Bleich, André; Abendroth, Philipp; Heemeier, Tanja; Ehlert, Nina; Behrens, Peter; Esser, Karl-Heinz; Lenarz, Thomas; Brandes, Gudrun; Prenzler, Nils K

    2015-07-01

    For several centuries silver is known for its antibacterial effects. The middle ear is an interesting new scope for silver application since chronic inflammations combined with bacterial infection cause complete destruction of the fragile ossicle chain and tympanic membrane. The resulting conductive deafness requires tympanoplasty for reconstruction. Strategies to prevent bacterial growth on middle ear prostheses are highly recommended. In this study, rabbits were implanted with Bioverit® II middle ear prostheses functionalized with silver containing dense and nanoporous silica films which were compared with pure silica coatings as well as silver sulfadiazine cream applied on nanoporous silica coating. The health status of animals was continuously monitored; blood was examined before and after implantation. After 21 days, the middle ears were inspected; implants and mucosal samples were processed for electron microscopy. Autopsies were performed and systemic spreading of silver was chemically analyzed exemplarily in liver and kidneys. For verification of direct cytotoxicity, NIH 3T3 cells were cultured on similar silver containing silica coatings on glass up to 3 days. In vitro a reduced viability of fibroblasts adhering directly on the samples was detected compared to cells growing on the surrounding plastic of the same culture dish. In transmission electron microscopy, phagocytosed silver silica fragments, silver sulfadiazine cream as well as silver nanoparticles were noticed inside endosomes. In vivo, clinical and post mortem examinations were inconspicuous. Chemical analyses showed no increased silver content compared to controls. Mucosal coverages on almost all prostheses were found. But reduction of granulation tissue was only obvious around silver-coated implants. Single necroses and apoptosis in the mucosa were correlated by intracellular accumulation of metallic silver. For confirming supportive healing effects of middle ear implants, silver ion

  4. Control of Middle Ear Inflammatory and Ion Homeostasis Genes by Transtympanic Glucocorticoid and Mineralocorticoid Treatments

    PubMed Central

    Lighthall, Jessyka G.; Kempton, J. Beth; Hausman, Frances; MacArthur, Carol J.; Trune, Dennis R.

    2015-01-01

    Hypothesis Transtympanic steroid treatment will induce changes in ion homeostasis and inflammatory gene expression to decrease middle ear inflammation due to bacterial inoculation. Background Otitis media is common, but treatment options are limited to systemic antibiotic therapy or surgical intervention. Systemic glucocorticoid treatment of mice decreases inflammation and improves fluid clearance. However, transtympanic delivery of glucocorticoids or mineralocorticoid has not been explored to determine if direct steroid application is beneficial. Methods Balb/c mice received transtympanic inoculation of heat-killed Haemophilus influenzae (H flu), followed by transtympanic treatment with either prednisolone or aldosterone. Mice given PBS instead of steroid and untreated mice were used as controls. Four hours after steroid treatment, middle ears were harvested for mRNA extraction and 24 hours after inoculation middle ears were harvested and examined for measures of inflammation. Results H flu inoculation caused the increased expression of nearly all inflammatory cytokine genes and induced changes in expression of several genes related to cellular junctions and transport channels. Both steroids generally reversed the expression of inflammatory genes and caused ion and water regulatory genes to return to normal or near normal levels. Histologic evaluation of middle ears showed improved fluid and inflammatory cell clearance. Conclusion Improvement in middle ear inflammation was noted with both the glucocorticoid prednisolone and the mineralocorticoid aldosterone. This was due to reversal of inflammation-induced changes in middle ear cytokine genes, as well as those involved in ion and water homeostasis. Because glucocorticoids bind to the mineralocorticoid receptor, but not the reverse, it is concluded that much of the reduction of fluid and other inflammation measures was due to these steroids impact on ion and water transport channels. Further research is necessary

  5. [The difficulties encountered in diagnostics of malignant neoplasms of the middle ear in the children].

    PubMed

    Zelikovich, E I; Kurilenkov, G V; Tuzhilina, K V

    2013-01-01

    The objective of the present work was to estimate the potential of CT and MRI diagnostics of malignant neoplasms of the middle ear in the children. Diagnostics of these tumours encounters great difficulties. We analysed the main subjective and objective causes underlying these difficulties and accounting for the late detection of the pathology being considered. Special attention is given to the possibilities of using CT and MRI techniques for diagnostics of malignant neoplasms of the middle ear in the children. The differential radiodiagnostic criteria for malignant tumours are proposed.

  6. Imaging appearances of unusual conditions of the middle and inner ear.

    PubMed

    Offiah, C E; Ramsden, R T; Gillespie, J E

    2008-06-01

    Requests for imaging of patients complaining of deafness and other symptoms related to the petrous bone are becoming increasingly common. Although much of this work is related to the exclusion of vestibular schwannomas by MRI, high-resolution CT is available in most departments and is necessary for the evaluation of many conditions of the middle ear and bony labyrinth. In this pictorial review, some of the more unusual conditions that may be encountered in the middle and inner ear are presented, which might not be overly familiar to non-otological radiologists, illustrating the roles of CT and MRI.

  7. Middle ear muscle contractions and their relation to pulse and echo evoked potentials in the bat

    NASA Technical Reports Server (NTRS)

    Henson, O. W., Jr.; Henson, M. M.

    1972-01-01

    An analysis is made of pulse and echo orientation cries of the Mustache Bat. That bat's cries are characterized by a long, 60 to 30 msec, pure tone component and brief beginning and terminal FM sweeps. In addition to obvious echo overlap and middle ear muscle contractions, the following are examined: (1) characteristics of pulse- and echo-evoked potential under various conditions, (2) evidence of changes in hearing sensitivity during and after pulse emission, and (3) the role of the middle ear muscles in bringing about these changes.

  8. Design, kinematic optimization, and evaluation of a teleoperated system for middle ear microsurgery.

    PubMed

    Miroir, Mathieu; Nguyen, Yann; Szewczyk, Jérôme; Sterkers, Olivier; Bozorg Grayeli, Alexis

    2012-01-01

    Middle ear surgery involves the smallest and the most fragile bones of the human body. Since microsurgical gestures and a submillimetric precision are required in these procedures, the outcome can be potentially improved by robotic assistance. Today, there is no commercially available device in this field. Here, we describe a method to design a teleoperated assistance robotic system dedicated to the middle ear surgery. Determination of design specifications, the kinematic structure, and its optimization are detailed. The robot-surgeon interface and the command modes are provided. Finally, the system is evaluated by realistic tasks in experimental dedicated settings and in human temporal bone specimens.

  9. The size of the mastoid air cell system among black and white children with middle ear effusion.

    PubMed

    Lindeman, P; Holmquist, J; Shea, J

    1981-09-01

    The incidence of middle ear disease among black American children is lower than among white children. Many factors may contribute to this difference. The possibility of an anatomical variation regarding the cellularity of the mastoid process was investigated. The size of the mastoid air cell system was measured in black and white children with and without middle ear effusion. A significantly smaller mastoid air cell system was found in the groups with middle ear disease compared to those without disease. No difference between white and black children in diseased as well as non-diseased ears could be demonstrated. PMID:7319703

  10. Presence of respiratory viruses in middle ear fluids and nasal wash specimens from children with acute otitis media.

    PubMed

    Chonmaitree, T; Howie, V M; Truant, A L

    1986-05-01

    During a 28-month period, 84 children with acute otitis media were studied by viral and bacterial cultures of middle ear fluid and viral cultures of nasal lavage fluid. Viruses were isolated from the middle ear fluid of 17 (20%) patients. Evidence of viral infection was demonstrated by positive viral cultures of middle ear fluid and/or nasal lavage fluid in 33 (39%) patients. Rhinovirus in one patient and influenza b virus in another were the only pathogens isolated. Influenza virus, enterovirus, and rhinovirus were the most common viruses found in middle ear fluids. Parainfluenza virus, adenovirus, and respiratory syncytial virus were found less often. In 82% of cases, the virus isolated from middle ear fluid was also isolated from nasal lavage fluid, but only 44% of viruses found in nasal lavage fluid were also found in middle ear fluid. Mixed bacterial and combined viral-bacterial infections were common. Only 15% of patients had no pathogen isolated from middle ear fluids. Using tissue culture techniques, we demonstrated that enterovirus and rhinovirus are also common middle ear pathogens. Our data reemphasize the significance of viruses as etiologic agents of acute otitis media and propose several questions regarding the viral-bacterial interactions and the types of viruses involved in the pathogenesis of the disease.

  11. Antibodies mediate formation of neutrophil extracellular traps in the middle ear and facilitate secondary pneumococcal otitis media.

    PubMed

    Short, Kirsty R; von Köckritz-Blickwede, Maren; Langereis, Jeroen D; Chew, Keng Yih; Job, Emma R; Armitage, Charles W; Hatcher, Brandon; Fujihashi, Kohtaro; Reading, Patrick C; Hermans, Peter W; Wijburg, Odilia L; Diavatopoulos, Dimitri A

    2014-01-01

    Otitis media (OM) (a middle ear infection) is a common childhood illness that can leave some children with permanent hearing loss. OM can arise following infection with a variety of different pathogens, including a coinfection with influenza A virus (IAV) and Streptococcus pneumoniae (the pneumococcus). We and others have demonstrated that coinfection with IAV facilitates the replication of pneumococci in the middle ear. Specifically, we used a mouse model of OM to show that IAV facilitates the outgrowth of S. pneumoniae in the middle ear by inducing middle ear inflammation. Here, we seek to understand how the host inflammatory response facilitates bacterial outgrowth in the middle ear. Using B cell-deficient infant mice, we show that antibodies play a crucial role in facilitating pneumococcal replication. We subsequently show that this is due to antibody-dependent neutrophil extracellular trap (NET) formation in the middle ear, which, instead of clearing the infection, allows the bacteria to replicate. We further demonstrate the importance of these NETs as a potential therapeutic target through the transtympanic administration of a DNase, which effectively reduces the bacterial load in the middle ear. Taken together, these data provide novel insight into how pneumococci are able to replicate in the middle ear cavity and induce disease.

  12. Streptococcus pneumoniae isolates from middle ear fluid and nasopharynx of children with acute otitis media exhibit phase variation.

    PubMed

    Arai, Jun; Hotomi, Muneki; Hollingshead, Susan K; Ueno, Yumi; Briles, David E; Yamanaka, Noboru

    2011-04-01

    Pneumococcal phase variation of 37 middle ear and 31 nasopharyngeal isolates obtained from children with acute otitis media was examined in the absence of intervening culture. The fraction of the opaque colonies was significantly higher in middle ear isolates than in nasopharyngeal isolates. The difference is probably the result of the pneumococci adapting to differential selective environments.

  13. In vivo imaging of middle-ear and inner-ear microstructures of a mouse guided by SD-OCT combined with a surgical microscope.

    PubMed

    Cho, Nam Hyun; Jang, Jeong Hun; Jung, Woonggyu; Kim, Jeehyun

    2014-04-21

    We developed an augmented-reality system that combines optical coherence tomography (OCT) with a surgical microscope. By sharing the common optical path in the microscope and OCT, we could simultaneously acquire OCT and microscope views. The system was tested to identify the middle-ear and inner-ear microstructures of a mouse. Considering the probability of clinical application including otorhinolaryngology, diseases such as middle-ear effusion were visualized using in vivo mouse and OCT images simultaneously acquired through the eyepiece of the surgical microscope during surgical manipulation using the proposed system. This system is expected to realize a new practical area of OCT application.

  14. 21 CFR 344.12 - Ear drying aid active ingredient.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 5 2014-04-01 2014-04-01 false Ear drying aid active ingredient. 344.12 Section 344.12 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED....12 Ear drying aid active ingredient. The active ingredient of the product consists of...

  15. 21 CFR 344.12 - Ear drying aid active ingredient.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 5 2012-04-01 2012-04-01 false Ear drying aid active ingredient. 344.12 Section 344.12 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED....12 Ear drying aid active ingredient. The active ingredient of the product consists of...

  16. 21 CFR 344.12 - Ear drying aid active ingredient.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 5 2011-04-01 2011-04-01 false Ear drying aid active ingredient. 344.12 Section 344.12 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED....12 Ear drying aid active ingredient. The active ingredient of the product consists of...

  17. 21 CFR 344.12 - Ear drying aid active ingredient.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 5 2010-04-01 2010-04-01 false Ear drying aid active ingredient. 344.12 Section 344.12 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED....12 Ear drying aid active ingredient. The active ingredient of the product consists of...

  18. 21 CFR 344.12 - Ear drying aid active ingredient.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 5 2013-04-01 2013-04-01 false Ear drying aid active ingredient. 344.12 Section 344.12 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED....12 Ear drying aid active ingredient. The active ingredient of the product consists of...

  19. Optical coherence tomography system requirements for clinical diagnostic middle ear imaging.

    PubMed

    MacDougall, Dan; Rainsbury, James; Brown, Jeremy; Bance, Manohar; Adamson, Robert

    2015-05-01

    Noninvasive middle ear imaging using optical coherence tomography (OCT) presents some unique challenges for real-time, clinical use in humans. We present results from a two-dimensional/three-dimensional OCT system built to assess the imaging requirements of clinical middle ear imaging, and the technical challenges associated with them. These include the need to work at a low numerical aperture, the deleterious effects of transtympanic imaging on image quality at the ossicles, sensitivity requirements for clinical fidelity of images at real-time rates, and the high dynamic-range requirements of the ear. We validated the system by imaging cadaveric specimens with simulated disorders to show the clinical applicability of the images. We also provide additional insight into the likely role of OCT in clinical otology.

  20. Silicone impression material foreign body in the middle ear: Two case reports and literature review.

    PubMed

    Suzuki, Nobuyoshi; Okamura, Koji; Yano, Takuya; Moteki, Hideaki; Kitoh, Ryosuke; Takumi, Yutaka; Usami, Shin-ichi

    2015-10-01

    We report two cases of impression material foreign body in the middle ear. The first case had been affected with chronic otitis media. The silicone flowed into the middle ear through a tympanic membrane perforation during the process of making an ear mold. About 4 years and 8 months after, the patient had severe vertigo and deafness. We found bone erosion of the prominence of the lateral semicircular canal and diagnosed labyrinthitis caused by silicone impression material. In the second case silicone flowed into the canal wall down mastoid cavity. Both cases required surgery to remove the foreign body. The clinical courses in such cases are variable and timing of surgery is sometimes difficult. In addition to reporting these two cases, we present here a review of the literature regarding impression material foreign bodies.

  1. Femtosecond laser microstructuring of titanium surfaces for middle ear ossicular replacement prosthesis: results of preliminary studies

    NASA Astrophysics Data System (ADS)

    Biedron, S.; Ilgner, J. F. R.; Fadeeva, E.; Chichkov, B.; Prescher, A.; Bovi, M.; Westhofen, M.

    2009-07-01

    The objective of this study was to optimize titanium surfaces by means of Ti:Sapphire femtosecond laser to improve the attachment of human cartilage cells on titanium prosthesis in middle ear surgery. The application of microstructures on titanium samples was evaluated and the influence of these microstructures on human auricular chondrocytes was studied in-vitro. After establishing the ear chondrocyte cell culture, cells were seeded on titanium platelets with selected microstructure patterns. Whereas the phenotype of cells seeded on unstructured titanium was similar to cells grown on standard tissue culture surfaces, the morphology of chondrocytes grown on structured titanium samples was influenced by the pattern. For future titanium middle ear prosthesis structural optimizations will be developed to promote chondrocyte growth and adhesion while impeding fibrocyte proliferation to avoid scarring on implant interfaces.

  2. Age and Gender Effects on Wideband Absorbance in Adults with Normal Outer and Middle Ear Function

    ERIC Educational Resources Information Center

    Mazlan, Rafidah; Kei, Joseph; Ya, Cheng Li; Yusof, Wan Nur Hanim Mohd; Saim, Lokman; Zhao, Fei

    2015-01-01

    Purpose: This study examined the effects of age and gender on wideband energy absorbance in adults with normal middle ear function. Method: Forty young adults (14 men, 26 women, aged 20-38 years), 31 middle-aged adults (16 men, 15 women, aged 42-64 years), and 30 older adults (20 men, 10 women, aged 65-82 years) were assessed. Energy absorbance…

  3. [Functional multispiral computed tomography of sound-transmitting structures in the middle ear].

    PubMed

    Bodrova, I V; Rusektskiĭ, Iu Iu; Kulakova, L A; Lopatin, A S; Ternovoĭ, S K

    2011-01-01

    The objective of this work was to estimate the potential of functional multispiral computed tomography (fMSCT) for the choice and planning of the treatment strategy and the extent of surgical intervention in the patients presenting with fibroosseous diseases of the middle ear associated with the pathologically altered mobility of the auditory ossicles. Studies with the use of MSCT and fMSCT for the examination of temporal bones in 21 patients (25 observations) provided information about normal CT anatomy of the middle ear and a basis for the development of the fMSCT protocol; moreover they allowed the range of mobility of the auditory ossicles to be determined in healthy subjects and patients with middle ear disorders. It is concluded that fMSCT of temporal bones may be recommended to patients suffering otosclerosis, tympanosclerosis, and adhesive otitis media. The use of this technique improves the accuracy of diagnosis and facilitates the choice and planning of the treatment strategy and the extent of surgical intervention in the patients presenting with middle ear diseases.

  4. Influenza A Virus Alters Pneumococcal Nasal Colonization and Middle Ear Infection Independently of Phase Variation

    PubMed Central

    Wren, John T.; Blevins, Lance K.; Pang, Bing; King, Lauren B.; Perez, Antonia C.; Murrah, Kyle A.; Reimche, Jennifer L.; Alexander-Miller, Martha A.

    2014-01-01

    Streptococcus pneumoniae (pneumococcus) is both a widespread nasal colonizer and a leading cause of otitis media, one of the most common diseases of childhood. Pneumococcal phase variation influences both colonization and disease and thus has been linked to the bacteria's transition from colonizer to otopathogen. Further contributing to this transition, coinfection with influenza A virus has been strongly associated epidemiologically with the dissemination of pneumococci from the nasopharynx to the middle ear. Using a mouse infection model, we demonstrated that coinfection with influenza virus and pneumococci enhanced both colonization and inflammatory responses within the nasopharynx and middle ear chamber. Coinfection studies were also performed using pneumococcal populations enriched for opaque or transparent phase variants. As shown previously, opaque variants were less able to colonize the nasopharynx. In vitro, this phase also demonstrated diminished biofilm viability and epithelial adherence. However, coinfection with influenza virus ameliorated this colonization defect in vivo. Further, viral coinfection ultimately induced a similar magnitude of middle ear infection by both phase variants. These data indicate that despite inherent differences in colonization, the influenza A virus exacerbation of experimental middle ear infection is independent of the pneumococcal phase. These findings provide new insights into the synergistic link between pneumococcus and influenza virus in the context of otitis media. PMID:25156728

  5. Acoustical transmission-line model of the middle-ear cavities and mastoid air cells.

    PubMed

    Keefe, Douglas H

    2015-04-01

    An acoustical transmission line model of the middle-ear cavities and mastoid air cell system (MACS) was constructed for the adult human middle ear with normal function. The air-filled cavities comprised the tympanic cavity, aditus, antrum, and MACS. A binary symmetrical airway branching model of the MACS was constructed using an optimization procedure to match the average total volume and surface area of human temporal bones. The acoustical input impedance of the MACS was calculated using a recursive procedure, and used to predict the input impedance of the middle-ear cavities at the location of the tympanic membrane. The model also calculated the ratio of the acoustical pressure in the antrum to the pressure in the middle-ear cavities at the location of the tympanic membrane. The predicted responses were sensitive to the magnitude of the viscothermal losses within the MACS. These predicted input impedance and pressure ratio functions explained the presence of multiple resonances reported in published data, which were not explained by existing MACS models.

  6. Inhaled toluene can modulate the effects of anesthetics on the middle-ear acoustic reflex.

    PubMed

    Campo, Pierre; Venet, Thomas; Thomas, Aurélie; Cour, Chantal; Castel, Blandine; Nunge, Hervé; Cosnier, Frédéric

    2013-01-01

    Toluene (Tol) is an organic solvent widely used in the industry. It is also abused as an inhaled solvent, and can have deleterious effects on hearing. Recently, it was demonstrated that Tol has both anticholinergic and antiglutamatergic effects, and that it also inhibits voltage-dependent Ca(2+) channels. This paper describes a study of the effects of inhaled Tol on rats anesthetized with isoflurane, pentobarbital, or a mixture of ketamine/xylazine. Hearing was tested using distortion product oto-acoustic emissions (DPOAEs) associated with a contralateral noise to evaluate contraction of the middle-ear muscles. This allowed us to assess the interactions between the effects of Tol and anesthesia on the central nervous system (CNS). Although both anesthetics and Tol are known to inhibit the middle-ear acoustic reflex, our data indicated that inhaled Tol counterbalances the effects of anesthetic in a dose-dependent manner. In other terms, Tol can increase the amplitude of the middle-ear reflex in anesthetized rats, whatever the nature of the anesthetic used. This indicates that inhaling Tol (a Ca(2+)-channel-blocking drug) modifies the potency of anesthesia, and thereby the amplitude of the middle-ear reflex.

  7. Acoustical transmission-line model of the middle-ear cavities and mastoid air cells

    PubMed Central

    Keefe, Douglas H.

    2015-01-01

    An acoustical transmission line model of the middle-ear cavities and mastoid air cell system (MACS) was constructed for the adult human middle ear with normal function. The air-filled cavities comprised the tympanic cavity, aditus, antrum, and MACS. A binary symmetrical airway branching model of the MACS was constructed using an optimization procedure to match the average total volume and surface area of human temporal bones. The acoustical input impedance of the MACS was calculated using a recursive procedure, and used to predict the input impedance of the middle-ear cavities at the location of the tympanic membrane. The model also calculated the ratio of the acoustical pressure in the antrum to the pressure in the middle-ear cavities at the location of the tympanic membrane. The predicted responses were sensitive to the magnitude of the viscothermal losses within the MACS. These predicted input impedance and pressure ratio functions explained the presence of multiple resonances reported in published data, which were not explained by existing MACS models. PMID:25920840

  8. Influenza A virus alters pneumococcal nasal colonization and middle ear infection independently of phase variation.

    PubMed

    Wren, John T; Blevins, Lance K; Pang, Bing; King, Lauren B; Perez, Antonia C; Murrah, Kyle A; Reimche, Jennifer L; Alexander-Miller, Martha A; Swords, W Edward

    2014-11-01

    Streptococcus pneumoniae (pneumococcus) is both a widespread nasal colonizer and a leading cause of otitis media, one of the most common diseases of childhood. Pneumococcal phase variation influences both colonization and disease and thus has been linked to the bacteria's transition from colonizer to otopathogen. Further contributing to this transition, coinfection with influenza A virus has been strongly associated epidemiologically with the dissemination of pneumococci from the nasopharynx to the middle ear. Using a mouse infection model, we demonstrated that coinfection with influenza virus and pneumococci enhanced both colonization and inflammatory responses within the nasopharynx and middle ear chamber. Coinfection studies were also performed using pneumococcal populations enriched for opaque or transparent phase variants. As shown previously, opaque variants were less able to colonize the nasopharynx. In vitro, this phase also demonstrated diminished biofilm viability and epithelial adherence. However, coinfection with influenza virus ameliorated this colonization defect in vivo. Further, viral coinfection ultimately induced a similar magnitude of middle ear infection by both phase variants. These data indicate that despite inherent differences in colonization, the influenza A virus exacerbation of experimental middle ear infection is independent of the pneumococcal phase. These findings provide new insights into the synergistic link between pneumococcus and influenza virus in the context of otitis media.

  9. Isolation of measles virus from middle ear fluid of infants with acute otitis media.

    PubMed

    Yano, Hisakazu; Suetake, Mitsuko; Endo, Hiroko; Takayanagi, Reiko; Numata, Mika; Ohyama, Kenji; Sagai, Shun; Okitsu, Naohiro; Okamoto, Michiko; Nishimura, Hidekazu; Kobayashi, Toshimitsu

    2005-11-01

    Measles virus was isolated from the middle ear fluid (MEF) of two infant cases of acute otitis media (AOM) associated with measles. This is the first report on the isolation of measles virus from the MEF in patients with AOM, and possibility of the measles virus as a causative agent of AOM was suggested.

  10. Fetal development of the elastic-fiber-mediated enthesis in the human middle ear.

    PubMed

    Takanashi, Yoshitaka; Shibata, Shunichi; Katori, Yukio; Murakami, Gen; Abe, Shinichi; Rodríguez-Vázquez, Jose Francisco; Kawase, Tetsuaki

    2013-10-01

    In the human middle ear, the annular ligament of the incudostapedial joint and the insertions of the tensor tympani and stapedius muscles contain abundant elastic fibers; i.e., the elastic-fiber-mediated entheses. Hyaluronan also coexists with the elastic fibers. In the present study using immunohistochemistry, we demonstrated the distribution of elastin not only in the incudostapedial joint but also in the other two joints of the middle ear in adults and fetuses. In adults, the expression of elastin did not extend out of the annular ligament composed of mature elastic fibers but clearly overlapped with it. Electron microscopic observations of the annular ligament demonstrated a few microfibrils along the elastic fibers. Thus, in contrast to the vocal cord, the middle ear entheses seemed not to contain elaunin and oxytalan fibers. In mid-term fetuses (at approximately 15-16 weeks of gestation) before opening of the external acoustic meatus, the incudostapedial joint showed abundant elastic fibers, but the incudomalleolar and stapediovestibular joints did not. At this stage, hyaluronan was not colocalized, but distributed diffusely in loose mesenchymal tissues surrounding the ear ossicles. Therefore, fetal development of elastin and elastic fibers in the middle ear entheses is unlikely to require acoustic oscillation. In late-stage fetuses (25-30 weeks), whose ear ossicles were almost the same size as those in adults, we observed bundling and branching of elastic fibers. However, hyaluronan expression was not as strong as in adults. Colocalization between elastic fibers and hyaluronan appeared to be a result of postnatal maturation of the entheses.

  11. Experimental measurement of tympanic membrane response for finite element model validation of a human middle ear.

    PubMed

    Ahn, Tae-Soo; Baek, Moo-Jin; Lee, Dooho

    2013-01-01

    The middle ear consists of a tympanic membrane, ligaments, tendons, and three ossicles. An important function of the tympanic membrane is to deliver exterior sound stimulus to the ossicles and inner ear. In this study, the responses of the tympanic membrane in a human ear were measured and compared with those of a finite element model of the middle ear. A laser Doppler vibrometer (LDV) was used to measure the dynamic responses of the tympanic membrane, which had the measurement point on the cone of light of the tympanic membrane. The measured subjects were five Korean male adults and a cadaver. The tympanic membranes were stimulated using pure-tone sine waves at 18 center frequencies of one-third octave band over a frequency range of 200 Hz ~10 kHz with 60 and 80 dB sound pressure levels. The measured responses were converted into the umbo displacement transfer function (UDTF) with a linearity assumption. The measured UDTFs were compared with the calculated UDTFs using a finite element model for the Korean human middle ear. The finite element model of the middle ear consists of three ossicles, a tympanic membrane, ligaments, and tendons. In the finite element model, the umbo displacements were calculated under a unit sound pressure on the tympanic membrane. The UDTF of the finite element model exhibited good agreement with that of the experimental one in low frequency range, whereas in higher frequency band, the two response functions deviated from each other, which demonstrates that the finite element model should be updated with more accurate material properties and/or a frequency dependent material model.

  12. A new model for non-typeable Haemophilus influenzae middle ear infection in the Junbo mutant mouse.

    PubMed

    Hood, Derek; Moxon, Richard; Purnell, Tom; Richter, Caroline; Williams, Debbie; Azar, Ali; Crompton, Michael; Wells, Sara; Fray, Martin; Brown, Steve D M; Cheeseman, Michael T

    2016-01-01

    Acute otitis media, inflammation of the middle ear, is the most common bacterial infection in children and, as a consequence, is the most common reason for antimicrobial prescription to this age group. There is currently no effective vaccine for the principal pathogen involved, non-typeable Haemophilus influenzae (NTHi). The most frequently used and widely accepted experimental animal model of middle ear infection is in chinchillas, but mice and gerbils have also been used. We have established a robust model of middle ear infection by NTHi in the Junbo mouse, a mutant mouse line that spontaneously develops chronic middle ear inflammation in specific pathogen-free conditions. The heterozygote Junbo mouse (Jbo/+) bears a mutation in a gene (Evi1, also known as Mecom) that plays a role in host innate immune regulation; pre-existing middle ear inflammation promotes NTHi middle ear infection. A single intranasal inoculation with NTHi produces high rates (up to 90%) of middle ear infection and bacterial titres (10(4)-10(5) colony-forming units/µl) in bulla fluids. Bacteria are cleared from the majority of middle ears between day 21 and 35 post-inoculation but remain in approximately 20% of middle ears at least up to day 56 post-infection. The expression of Toll-like receptor-dependent response cytokine genes is elevated in the middle ear of the Jbo/+ mouse following NTHi infection. The translational potential of the Junbo model for studying antimicrobial intervention regimens was shown using a 3 day course of azithromycin to clear NTHi infection, and its potential use in vaccine development studies was shown by demonstrating protection in mice immunized with killed homologous, but not heterologous, NTHi bacteria. PMID:26611891

  13. A new model for non-typeable Haemophilus influenzae middle ear infection in the Junbo mutant mouse

    PubMed Central

    Hood, Derek; Moxon, Richard; Purnell, Tom; Richter, Caroline; Williams, Debbie; Azar, Ali; Crompton, Michael; Wells, Sara; Fray, Martin; Brown, Steve D. M.; Cheeseman, Michael T.

    2016-01-01

    ABSTRACT Acute otitis media, inflammation of the middle ear, is the most common bacterial infection in children and, as a consequence, is the most common reason for antimicrobial prescription to this age group. There is currently no effective vaccine for the principal pathogen involved, non-typeable Haemophilus influenzae (NTHi). The most frequently used and widely accepted experimental animal model of middle ear infection is in chinchillas, but mice and gerbils have also been used. We have established a robust model of middle ear infection by NTHi in the Junbo mouse, a mutant mouse line that spontaneously develops chronic middle ear inflammation in specific pathogen-free conditions. The heterozygote Junbo mouse (Jbo/+) bears a mutation in a gene (Evi1, also known as Mecom) that plays a role in host innate immune regulation; pre-existing middle ear inflammation promotes NTHi middle ear infection. A single intranasal inoculation with NTHi produces high rates (up to 90%) of middle ear infection and bacterial titres (104-105 colony-forming units/µl) in bulla fluids. Bacteria are cleared from the majority of middle ears between day 21 and 35 post-inoculation but remain in approximately 20% of middle ears at least up to day 56 post-infection. The expression of Toll-like receptor-dependent response cytokine genes is elevated in the middle ear of the Jbo/+ mouse following NTHi infection. The translational potential of the Junbo model for studying antimicrobial intervention regimens was shown using a 3 day course of azithromycin to clear NTHi infection, and its potential use in vaccine development studies was shown by demonstrating protection in mice immunized with killed homologous, but not heterologous, NTHi bacteria. PMID:26611891

  14. Comparison of different computed tomography post-processing modalities in assessment of various middle ear disorders.

    PubMed

    Mehanna, Ahmed Mohamed; Baki, Fatthi Abdel; Eid, Mohamed; Negm, Magdy

    2015-06-01

    Several anatomic structures of the middle ear are not optimally depicted in the standard axial and coronal planes. Several 2D and 3D image-processing modalities are currently available for CT examinations in clinical radiology departments. Till now 3D reconstructions of the temporal bone have not been widely used yet, and attracted only academic interest. The aim of this study was to compare axial (source images), 2D and 3DCT post-processing modalities, and to evaluate the value of 3D reconstructed images/virtual endoscopy (VE) in assessment of various middle ear disorders for identification of the best modality/view for assessment of a particular middle ear structure or pathology. 40 patients with various middle ear disorders, planned for surgical intervention were included in prospective study. Multi-slice CT was performed for all patients. Scans were acquired in the axial plane. The axial source datasets were utilized for generation of 2D reformations and 3D reconstructed images. All studied images were divided into three categories: axial (source images), 2D reformations (MPR and sliding-thin-slab MIP) and 3D reconstruction (virtual endoscopy). The visibility of middle ear structures and pathologies with each modality were scored qualitatively using three-point scoring system in reference to operative findings. Stapes superstructure and footplate, incudostapedial joint, oval and round windows, tympanic segment of the facial nerve and tegmen were not optimally depicted in the axial plane. Sinus tympani and facial recess were best visualized with axial images or VE. 3D reconstruction/VE allowed good visualization of all parts of ossicular chain except stapes superstructure. Regarding pathologic changes, 2D reformations and 3D reconstructed images allowed better visualization of erosion of ossicles and tegmen. 3D reconstruction/VE did not allow detection of foci of otospongiosis. 2D reformations can be considered the mainstay in assessment of most middle ear

  15. Green laser light activates the inner ear

    NASA Astrophysics Data System (ADS)

    Wenzel, Gentiana I.; Balster, Sven; Zhang, Kaiyin; Lim, Hubert H.; Reich, Uta; Massow, Ole; Lubatschowski, Holger; Ertmer, Wolfgang; Lenarz, Thomas; Reuter, Guenter

    2009-07-01

    The hearing performance with conventional hearing aids and cochlear implants is dramatically reduced in noisy environments and for sounds more complex than speech (e. g. music), partially due to the lack of localized sensorineural activation across different frequency regions with these devices. Laser light can be focused in a controlled manner and may provide more localized activation of the inner ear, the cochlea. We sought to assess whether visible light with parameters that could induce an optoacoustic effect (532 nm, 10-ns pulses) would activate the cochlea. Auditory brainstem responses (ABRs) were recorded preoperatively in anesthetized guinea pigs to confirm normal hearing. After opening the bulla, a 50-μm core-diameter optical fiber was positioned in the round window niche and directed toward the basilar membrane. Optically induced ABRs (OABRs), similar in shape to those of acoustic stimulation, were elicited with single pulses. The OABR peaks increased with energy level (0.6 to 23 μJ/pulse) and remained consistent even after 30 minutes of continuous stimulation at 13 μJ, indicating minimal or no stimulation-induced damage within the cochlea. Our findings demonstrate that visible light can effectively and reliably activate the cochlea without any apparent damage. Further studies are in progress to investigate the frequency-specific nature and mechanism of green light cochlear activation.

  16. Elastic fiber-mediated enthesis in the human middle ear.

    PubMed

    Kawase, Tetsuaki; Shibata, Shunichi; Katori, Yukio; Ohtsuka, Aiji; Murakami, Gen; Fujimiya, Mineko

    2012-10-01

    Adaptation to constant vibration (acoustic oscillation) is likely to confer a specific morphology at the bone-tendon and bone-ligament interfaces at the ear ossicles, which therefore represent an exciting target of enthesis research. We histologically examined (i) the bone attachments of the tensor tympani and stapedius muscles and (ii) the annular ligament of the incudostapedial joint obtained from seven elderly donated cadavers. Notably, both aldehyde-fuchsin and elastic-Masson staining demonstrated that the major fibrous component of the entheses was not collagen fibers but mature elastic fibers. The positive controls for elastic fiber staining were the arterial wall elastic laminae included in the temporal bone materials. The elastic fibers were inserted deeply into the type II collagen-poor fibrocartilage covering the ear ossicles. The muscle tendons were composed of an outer thin layer of collagen fibers and an inner thick core of elastic fibers near the malleus or stapes. In the unique elastic fiber-mediated entheses, hyaluronan, versican and fibronectin were expressed strongly along the elastic fibers. The hyaluronan seemed to act as a friction-reducing lubricant for the elastic fibers. Aggrecan was labeled strongly in a disk- or plica-like fibrous mass on the inner side of the elastic fiber-rich ligament, possibly due to compression stress from the ligament. Tenascin-c was not evident in the entheses. The elastic fiber-mediated entheses appeared resistant to tissue destruction in an environment exposed to constant vibration. The morphology was unlikely to be the result of age-related degeneration.

  17. Role of interleukin 6 in epithelial hyperproliferation and bone resorption in middle ear cholesteatomas.

    PubMed

    Bujía, J; Kim, C; Ostos, P; Kastenbauer, E; Hültner, L

    1996-01-01

    Locally produced pro-inflammatory cytokines are considered to play an important role in the initiation and/or maintenance of inflammatory diseases. In cholesteatomatous lesions there are increased levels of some cytokines and inflammatory mediators like interleukin 1, tumor necrosis factor and colony-stimulating factor, etc. Interleukin 6 (IL-6) can be produced by different cells present in cholesteatoma (e.g. keratinocytes, lymphocytes, fibroblasts and macrophages). Until now, no data have been available on the role of IL-6 in cholesteatoma. In this study we used immunohistochemistry to investigate the presence and distribution of IL-6 in tissue samples from cholesteatoma patients. Levels of the cytokine were quantified in tissue extracts using an enzyme-linked immunosorbent assay. Finally, the presence of biologically active IL-6 was analyzed in the murine cell line 7TD1. Human skin samples obtained from the external ear canal were used as controls. Using the anti-IL-6 antibody in an alkaline phosphatase anti alkaline phosphatase technique, a moderate diffuse staining of the whole epidermis was observed in sections of normal skin. In cryostat sections of cholesteatoma samples, a stronger staining of the whole epithelium was observed. Many of the cells infiltrating the cholesteatoma stroma also showed positive immunostainings. The concentration of IL-6 in relation to the total protein concentration in cholesteatoma (119.33 +/- 30) were higher than in human skin (9.16 +/- 13). While IL-6 activity was not detected in skin samples, two of the ten cholesteatoma samples studied showed a stimulatory effect when incubated with the cell line 7TD1. The overexpression of IL-6 in middle ear cholesteatoma suggests a participation of this cytokine in some of the clinical features seen: epithelial hyperproliferation and bone resorption. The absence of biological activity in the majority of the cholesteatoma samples points to the presence of natural inhibitors for IL-6.

  18. Epidermal growth factor receptor as a novel molecular target for aggressive papillary tumors in the middle ear and temporal bone

    PubMed Central

    Kawabata, Shigeru; Christine Hollander, M; Munasinghe, Jeeva P.; Brinster, Lauren R.; Mercado-Matos, José R.; Li, Jie; Regales, Lucia; Pao, William; Jänne, Pasi A.; Wong, Kwok-Kin; Butman, John A.; Lonser, Russell R.; Hansen, Marlan R.; Gurgel, Richard K.; Vortmeyer, Alexander O.; Dennis, Phillip A.

    2015-01-01

    Adenomatous tumors in the middle ear and temporal bone are rare but highly morbid because they are difficult to detect prior to the development of audiovestibular dysfunction. Complete resection is often disfiguring and difficult because of location and the late stage at diagnosis, so identification of molecular targets and effective therapies is needed. Here, we describe a new mouse model of aggressive papillary ear tumor that was serendipitously discovered during the generation of a mouse model for mutant EGFR-driven lung cancer. Although these mice did not develop lung tumors, 43% developed head tilt and circling behavior. Magnetic resonance imaging (MRI) scans showed bilateral ear tumors located in the tympanic cavity. These tumors expressed mutant EGFR as well as active downstream targets such as Akt, mTOR and ERK1/2. EGFR-directed therapies were highly effective in eradicating the tumors and correcting the vestibular defects, suggesting these tumors are addicted to EGFR. EGFR activation was also observed in human ear neoplasms, which provides clinical relevance for this mouse model and rationale to test EGFR-targeted therapies in these rare neoplasms. PMID:26027747

  19. Modeling sound transmission of human middle ear and its clinical applications using finite element analysis.

    PubMed

    Chen, Shou-I; Lee, Ming-Hsiao; Yao, Chih-Min; Chen, Peir-Rong; Chou, Yuan-Fang; Liu, Tien-Chen; Song, Yu-Lin; Lee, Chia-Fone

    2013-03-01

    We have developed a new finite element (FE) model of human right ear, including the accurate geometry of middle ear ossicles, external ear canal, tympanic cavity, and mastoid cavity. The FE model would be suitable to study the dynamic behaviors of pathological middle ear conditions, including changes of stapedial ligament stiffness, tensor tympani ligament (TTL), and tympanic membrane (TM) stiffness and thickness. Increasing stiffness of stapedial ligament has substantial effect on stapes footplate movement, especially at low frequencies, but less effect on umbo movement. Softer TTL will result in increasing umbo and stapes footplate displacement, especially at low frequencies (f<1000Hz). When the TTL was detached, the vibration amplitude of umbo increased by 6dB at 600Hz and two peaks (300 and 600Hz) were found in the vibration amplitude of stapes footplate. Increasing the stiffness of tensor tympani resulted in a slightly decreased umbo amplitude at very low frequencies (f<500Hz) and significantly decreased displacement up to 12dB at middle frequencies (1000Hz1500Hz. As (TM) thickness was increased, the umbo displacement was reduced, especially at very low frequencies (f<600Hz). Otherwise, the stapes displacement was reduced at all frequencies. PMID:23465416

  20. Measurements of Middle Ear Pressure Gain and Cochlear Input Impedance in the Chinchilla

    NASA Astrophysics Data System (ADS)

    Slama, Michael C. C.; Ravicz, Michael E.; Nakajima, Hideko H.; Dong, Wei; Rosowski, John J.

    2009-02-01

    Measurements of middle ear conducted sound pressure in the cochlear vestibule PV have been performed in only a few species. Simultaneous measurements of sound-induced stapes velocity Vs are even more rare. We report simultaneous measurements of VS and PV in chinchillas. The VS measurements are performed using single-beam laser-Doppler vibrometry; PV is measured with fiber-optic pressure sensors like those described by Olson [1]. PV and VS have been measured in six animals, and the middle ear pressure gain (ratio of PV to the sound pressure in the ear canal) and the cochlear input impedance (ratio of PV to the product of VS and area of the footplate) computed. Our measurements of middle ear pressure gain are similar to published data in the chinchilla at stimulus frequencies of 500 Hz to 3 kHz, but are different at other frequencies. Our measurements of cochlear input impedance differ somewhat from previous estimates in the chinchilla and show a resistive input impedance up to at least 10 kHz.

  1. Specialization for underwater hearing by the tympanic middle ear of the turtle, Trachemys scripta elegans

    PubMed Central

    Christensen-Dalsgaard, Jakob; Brandt, Christian; Willis, Katie L.; Christensen, Christian Bech; Ketten, Darlene; Edds-Walton, Peggy; Fay, Richard R.; Madsen, Peter T.; Carr, Catherine E.

    2012-01-01

    Turtles, like other amphibious animals, face a trade-off between terrestrial and aquatic hearing. We used laser vibrometry and auditory brainstem responses to measure their sensitivity to vibration stimuli and to airborne versus underwater sound. Turtles are most sensitive to sound underwater, and their sensitivity depends on the large middle ear, which has a compliant tympanic disc attached to the columella. Behind the disc, the middle ear is a large air-filled cavity with a volume of approximately 0.5 ml and a resonance frequency of approximately 500 Hz underwater. Laser vibrometry measurements underwater showed peak vibrations at 500–600 Hz with a maximum of 300 µm s−1 Pa−1, approximately 100 times more than the surrounding water. In air, the auditory brainstem response audiogram showed a best sensitivity to sound of 300–500 Hz. Audiograms before and after removing the skin covering reveal that the cartilaginous tympanic disc shows unchanged sensitivity, indicating that the tympanic disc, and not the overlying skin, is the key sound receiver. If air and water thresholds are compared in terms of sound intensity, thresholds in water are approximately 20–30 dB lower than in air. Therefore, this tympanic ear is specialized for underwater hearing, most probably because sound-induced pulsations of the air in the middle ear cavity drive the tympanic disc. PMID:22438494

  2. Specialization for underwater hearing by the tympanic middle ear of the turtle, Trachemys scripta elegans.

    PubMed

    Christensen-Dalsgaard, Jakob; Brandt, Christian; Willis, Katie L; Christensen, Christian Bech; Ketten, Darlene; Edds-Walton, Peggy; Fay, Richard R; Madsen, Peter T; Carr, Catherine E

    2012-07-22

    Turtles, like other amphibious animals, face a trade-off between terrestrial and aquatic hearing. We used laser vibrometry and auditory brainstem responses to measure their sensitivity to vibration stimuli and to airborne versus underwater sound. Turtles are most sensitive to sound underwater, and their sensitivity depends on the large middle ear, which has a compliant tympanic disc attached to the columella. Behind the disc, the middle ear is a large air-filled cavity with a volume of approximately 0.5 ml and a resonance frequency of approximately 500 Hz underwater. Laser vibrometry measurements underwater showed peak vibrations at 500-600 Hz with a maximum of 300 µm s(-1) Pa(-1), approximately 100 times more than the surrounding water. In air, the auditory brainstem response audiogram showed a best sensitivity to sound of 300-500 Hz. Audiograms before and after removing the skin covering reveal that the cartilaginous tympanic disc shows unchanged sensitivity, indicating that the tympanic disc, and not the overlying skin, is the key sound receiver. If air and water thresholds are compared in terms of sound intensity, thresholds in water are approximately 20-30 dB lower than in air. Therefore, this tympanic ear is specialized for underwater hearing, most probably because sound-induced pulsations of the air in the middle ear cavity drive the tympanic disc.

  3. Middle ear dynamics in response to seismic stimuli in the Cape golden mole (Chrysochloris asiatica).

    PubMed

    Willi, U B; Bronner, G N; Narins, P M

    2006-01-01

    The hypertrophied malleus in the middle ear of some golden moles has been assumed to be an adaptation for sensing substrate vibrations by inertial bone conduction, but this has never been conclusively demonstrated. The Cape golden mole (Chrysochloris asiatica) exhibits this anatomical specialization, and the dynamic properties of its middle ear response to vibrations were the subjects of this study. Detailed three-dimensional middle ear anatomy was obtained by x-ray microcomputed tomography (muCT) at a resolution of 12 microm. The ossicular chain exhibits large malleus mass, selective reduction of stiffness and displacement of the center of mass from the suspension points, all favoring low-frequency tuning of the middle ear response. Orientation of the stapes relative to the ossicular chain and the structure of the stapes footplate enable transmission of substrate vibrations arriving from multiple directions to the inner ear. With the long axes of the mallei aligned parallel to the surface, the animal's head was stimulated by a vibration exciter in the vertical and lateral directions over a frequency range from 10 to 600 Hz. The ossicular chain was shown to respond to both vertical and lateral vibrations. Resonant frequencies were found between 71 and 200 Hz and did not differ significantly between the two stimulation directions. Below resonance, the ossicular chain moves in phase with the skull. Near resonance and above, the malleus moves at a significantly larger mean amplitude (5.8+/-2.8 dB) in response to lateral vs vertical stimuli and is 180 degrees out of phase with the skull in both cases. A concise summary of the propagation characteristics of both seismic body (P-waves) and surface (R-waves) is provided. Potential mechanisms by which the animal might exploit the differential response of the ossicular chain to vertical and lateral excitation are discussed in relation to the properties of surface seismic waves.

  4. [Revision after surgical procedures in the middle ear and mastoid].

    PubMed

    Zelený, M; Navrátilová, A

    1989-03-01

    In a group of 46 revised operations the most frequent cause of revision was persisting secretion--in 41 patients. After elimination of general causes and after failure of conservative treatment, during revision the following local causes were revealed: relapse of cholesteatoma in 44%, inflammation of the residual or repneumatized spaces in 41%, ostitis of the long process of the incus in 10% and inflammation in the divided trepanation cavities in 5%. By the first revision the authors achieved a dry trepanation cavity in 58.5% of the operated patients. By the second and third revision they increased the number of dry trepanation cavities to 83% and in the remaining ones there was only an occasional secretion. The revision involved usually a more radical procedure. In some of the patients operated by the "closed" technique the authors changed to the "open" technique. A radical approach to the auditory ossicles and the ear drum, if they were preserved during the primary operation, led to a deterioration of hearing in 22 of 41 operated patients, i. e. in 53.66%. This is the cost of obtaining a dry trepanation cavity. PMID:2731259

  5. Morphogenesis of the middle ear ossicles and spatial relationships with the external and inner ears during the embryonic period.

    PubMed

    Ozeki-Satoh, Maimi; Ishikawa, Aoi; Yamada, Shigehito; Uwabe, Chigako; Takakuwa, Tetsuya

    2016-10-01

    We describe the three-dimensional morphogenesis of the middle ear ossicles (MEOs) according to Carnegie stage (CS) in human embryos. Seventeen samples including 33 MEOs from CS18 to 23 were selected from the Kyoto Collection. The primordia of the MEOs and related structures were histologically observed and three-dimensionally reconstructed from digital images. The timing of chondrogenesis was variable among structures. The stapes was recognizable as a vague condensation of the mesenchymal cells in all samples from CS18, whereas the malleus and incus were recognizable at CS19. Chondrogenesis of all MEOs was evident in all samples after CS21. The chondrocranium was recognizable in all samples by CS18, and the perichondrium border of the auricular cartilage and otic capsule was distinct in all samples at CS23. At CS19, the MEOs were positioned in the anterior to posterior direction, following the order malleus, incus, stapes, which adjusted gradually during development. The MEOs connected in all samples after CS22. The stapes was located close to the vestibular part of the inner ear, although the basal part was not differentiated into the "footplate" form, even at CS23. The handles of the malleus were close to the tubotympanic recess at CS23, but were distant from the external auditory meatus. Determining the timeline of the formation of MEOs and connection of the external and inner ears can be informative for understanding hearing loss caused by failure of this connection. These data may provide a useful standard for morphogenesis, and will contribute to distinguishing between normal and abnormal MEO development. Anat Rec, 299:1325-1337, 2016. © 2016 Wiley Periodicals, Inc.

  6. Round Window Membrane Implantation with an Active Middle Ear Implant: A Study of the Effects on the Performance of Round Window Exposure and Transducer Tip Diameter in Human Cadaveric Temporal Bones

    PubMed Central

    Tringali, Stéphane; Koka, Kanthaiah; Deveze, Arnaud; Holland, N. Julian; Jenkins, Herman A.; Tollin, Daniel J.

    2010-01-01

    Objectives To assess the importance of 2 variables, transducer tip diameter and resection of the round window (RW) niche, affecting the optimization of the mechanical stimulation of the RW membrane with an active middle ear implant (AMEI). Materials and Methods: Ten temporal bones were prepared with combined atticotomy and facial recess approach to expose the RW. An AMEI stimulated the RW with 2 ball tip diameters (0.5 and 1.0 mm) before and after the resection of the bony rim of the RW niche. The RW drive performance, assessed by stapes velocities using laser Doppler velocimetry, was analyzed in 3 frequency ranges: low (0.25–1 kHz), medium (1–3 kHz) and high (3–8 kHz). Results Driving the RW produced mean peak stapes velocities (HEV) of 0.305 and 0.255 mm/s/V at 3.03 kHz, respectively, for the 1- and 0.5-mm tips, with the RW niche intact. Niche drilling increased the HEV to 0.73 and 0.832 mm/s/V for the 1- and 0.5-mm tips, respectively. The tip diameter produced no difference in output at low and medium frequencies; however, the 0.5-mm tip was 5 and 6 dB better than the 1-mm tip at high frequencies before and after niche drilling, respectively. Drilling the niche significantly improved the output by 4 dB at high frequencies for the 1-mm tip, and by 6 and 10 dB in the medium- and high-frequency ranges for the 0.5-mm tip. Conclusion The AMEI was able to successfully drive the RW membrane in cadaveric temporal bones using a classical facial recess approach. Stimulation of the RW membrane with an AMEI without drilling the niche is sufficient for successful hearing outputs. However, the resection of the bony rim of the RW niche significantly improved the RW stimulation at medium and higher frequencies. Drilling the niche enhances the exposure of the RW membrane and facilitates positioning the implant tip. PMID:20150727

  7. Replication of type 5 adenovirus promotes middle ear infection by Streptococcus pneumoniae in the chinchilla model of otitis media

    PubMed Central

    Murrah, Kyle A.; Turner, Roberta L.; Pang, Bing; Perez, Antonia C.; Reimche, Jennifer L.; King, Lauren B.; Wren, John; Gandhi, Uma; Swords, W. Edward; Ornelles, David A.

    2015-01-01

    Adenoviral infection is a major risk factor for otitis media. We hypothesized that adenovirus promotes bacterial ascension into the middle ear through the disruption of normal function in the Eustachian tubes due to inflammation-induced changes. An intranasal infection model of the chinchilla was used to test the ability of type 5 adenovirus to promote middle ear infection by Streptococcus pneumoniae. The hyperinflammatory adenovirus mutant dl327 and the nonreplicating adenovirus mutant H5wt300ΔpTP were used to test the role of inflammation and viral replication, respectively, in promotion of pneumococcal middle ear infection. Precedent infection with adenovirus resulted in a significantly greater incidence of middle ear disease by S. pneumoniae as compared to nonadenovirus infected animals. Infection with the adenovirus mutant dl327 induced a comparable degree of bacterial ascension into the middle ear as did infection with the wild-type virus. By contrast, infection with the nonreplicating adenovirus mutant H5wt300ΔpTP resulted in less extensive middle ear infection compared to the wild-type adenovirus. We conclude that viral replication is necessary for adenoviral-induced pneumococcal middle ear disease. PMID:25251686

  8. Replication of type 5 adenovirus promotes middle ear infection by Streptococcus pneumoniae in the chinchilla model of otitis media.

    PubMed

    Murrah, Kyle A; Turner, Roberta L; Pang, Bing; Perez, Antonia C; Reimche, Jennifer L; King, Lauren B; Wren, John; Gandhi, Uma; Swords, W Edward; Ornelles, David A

    2015-03-01

    Adenoviral infection is a major risk factor for otitis media. We hypothesized that adenovirus promotes bacterial ascension into the middle ear through the disruption of normal function in the Eustachian tubes due to inflammation-induced changes. An intranasal infection model of the chinchilla was used to test the ability of type 5 adenovirus to promote middle ear infection by Streptococcus pneumoniae. The hyperinflammatory adenovirus mutant dl327 and the nonreplicating adenovirus mutant H5wt300ΔpTP were used to test the role of inflammation and viral replication, respectively, in promotion of pneumococcal middle ear infection. Precedent infection with adenovirus resulted in a significantly greater incidence of middle ear disease by S. pneumoniae as compared to nonadenovirus infected animals. Infection with the adenovirus mutant dl327 induced a comparable degree of bacterial ascension into the middle ear as did infection with the wild-type virus. By contrast, infection with the nonreplicating adenovirus mutant H5wt300ΔpTP resulted in less extensive middle ear infection compared to the wild-type adenovirus. We conclude that viral replication is necessary for adenoviral-induced pneumococcal middle ear disease.

  9. A silastic prosthesis for total replacement of the middle-ear ossicular chain, its acoustic properties and clinical application.

    PubMed

    Voldrich, Z; Skvor, Z; Novák, V; Zelený, M; Rufer, L

    1989-01-01

    The authors designed and made a prosthesis for total replacement of the middle ear ossicular chain (TORP) from Silastic MDX 44-516. A great advantage of this substitute is that it can easily be modified to a prosthesis for partial replacement of the middle-ear ossicular chain (PORP). The transfer properties of the PORP type prosthesis were verified by using an electroacoustic model measurement. Very good anatomical and functional results were obtained in the clinical testing of both types of middle-ear substitutes. No undesired reactions to the implanted polymer were observed. PMID:2641402

  10. [Clinical evaluation of congenital cholesteatoma of the middle ear].

    PubMed

    Kikuchi, Masahiro; Yamamoto, Etsuo; Shinohara, Shogo; Shiomi, Yousaku; Fujiwara, Keizo; Shiomi, Yoshiko; Watanabe, Futoshi; Tanabe, Makito

    2003-08-01

    We conducted a retrospective study to identify the clinical features and surgical observations of congenital cholesteatoma. Sixty patients were diagnosed and underwent surgery for congenital cholesteatoma between April 1987 and May 2002. All diagnoses were made on the basis of two operative findings: 1. the tympanic membrane manifested neither retraction, perforation, nor granulation. 2. the tympanic membrane was not continuous with the cholesteatoma. In this series, congenital cholesteatoma accounted for 7% of all cholesteatomas (853 ears). The patient age ranged from 2 to 48 years. The male to female ratio was 4:1. Seventeen patients had multiple cholesteatoma. Fifty-three patients exhibited closed-type cholesteatomas, while the remaining 7 patients had open-type cholesteatomas that had formed as a flat surface of the epidermis. Patients with open-type cholesteatomas presented with a much more pronounced conductive hearing loss and ossicular erosion or malformation. Twenty-two patients with relatively small cholesteatomas were analyzed to estimate the origin of their cholesteatomas. Of the 22 patients, 13 had anterior superior quadrant (ASQ-type) and 9 had posterior superior quadrant (PSQ-type) cholesteatomas. The mean age at the time of detection was older in the PSQ-type group than in the ASQ-type group and the frequency of ossicular erosion or malformation was more prominent in the PSQ-type group than in the ASQ-type group. The primary site of origin was thought to be the portion between the tympanic ostium of the auditory canal and the semicanal for tensor tympani in the ASQ-type group and near the incudostapedial joint in the PSQ-type group. A planned staged procedure was performed in 29 patients, 15 patients (52%) had residual lesions situated mostly on the oval window, the round window, an exposed facial nerve or an exposed lateral semicircular canal. The frequency of residual lesions in patients who presented with extended, multiple cholesteatoma and

  11. Bone conduction responses of middle ear structures in Thiel embalmed heads

    NASA Astrophysics Data System (ADS)

    Arnold, Andreas; Stieger, Christof; Caversaccio, Marco; Kompis, Martin; Guignard, Jérémie

    2015-12-01

    Thiel-embalmed human whole-head specimens offer a promising alternative model for bone conduction (BC) studies of middle ear structures. In this work we present the Thiel model's linearity and stability over time as well as its possible use in the study of a fixed ossicle chain. Using laser Doppler vibrometry (LDV), the motion of the retroauricular skull, the promontory, the stapes footplate and the round window (RW) were measured. A bone-anchored hearing aid stimulated the ears with step sinus tones logarithmically spread between 0.1 and 10 kHz. Linearity of the model was verified using input levels in steps of 10 dBV. The stability of the Thiel model over time was examined with measurements repeated after hours and weeks. The influence of a cement-fixed stapes was assessed. The middle ear elements measured responded linearly in amplitude for the applied input levels (100, 32.6, and 10 mV). The variability of measurements for both short- (2 h) and long-term (4-16 weeks) repetitions in the same ear was lower than the interindividual difference. The fixation of the stapes induced a lowered RW displacement for frequencies near 750 Hz (-4 dB) and an increased displacement for frequencies above 1 kHz (max. +3.7 dB at 4 kHz). LDV assessment of BC-induced middle ear motion in Thiel heads can be performed with stable results. The vibratory RW response is affected by the fixation of the stapes, indicating a measurable effect of ossicle chain inertia on BC response in Thiel embalmed heads.

  12. Middle ear injury through the external auditory canal: a review of 44 cases.

    PubMed

    Lasak, John M; Van Ess, Mark; Kryzer, Thomas C; Cummings, Richard J

    2006-11-01

    We performed a retrospective review of 44 patients with middle ear injury incurred through the external auditory canal. Twenty-two of the 44 patients had presented to our center within 1 month of their injury (early group), and 22 presented later (delayed group); the mean interval from the time of the trauma to presentation was 6 days in the early group and 7 years in the delayed group. The causes of injury were penetrating trauma (70% of cases), thermal insults (20%), and explosive and nonexplosive blasts (9%). Purulent otorrhea, cholesteatoma, and ossicular discontinuity were more common in the delayed group. Otologic surgery was required in 9 early-group patients (41%) and in all 22 delayed-group patients (100%). Two patients in the early group developed a dead ear. The mean pure-tone averages (PTAs) at presentation were 30.7 and 52.2 dB in the early and delayed groups, respectively; after management, the corresponding mean PTAs were 21.0 and 42.5 dB. The respective mean air-bone gaps in the two groups were 14.6 and 28.2 dB at presentation and 8.0 and 17.2 dB after management. We conclude that middle ear injury incurred as a result of trauma sustained through the external auditory canal is associated with considerable morbidity. Patients who present in a delayed fashion have significantly poorer hearing at presentation and after management. Patients who do not develop a dead ear generally derive benefit from reconstruction of the middle ear sound-conduction mechanism.

  13. Household number associated with middle ear disease at an urban Indigenous health service: a cross-sectional study.

    PubMed

    Spurling, Geoffrey K P; Askew, Deborah A; Schluter, Philip J; Simpson, Fiona; Hayman, Noel E

    2014-01-01

    Few epidemiological studies of middle ear disease have been conducted in Aboriginal and Torres Strait Islander populations, yet the disease is common and causes hearing impairment and poorer educational outcomes. The objective of this study is to identify factors associated with abnormal middle ear appearance, a proxy for middle ear disease. Aboriginal and Torres Strait Islander children aged 0-14 years receiving a Child Health Check (CHC) at an urban Indigenous Health Service, Brisbane, Australia were recruited from 2007 to 2010. Mixed-effects models were used to explore associations of 10 recognised risk factors with abnormal middle ear appearance at the time of the CHC. Ethical approval and community support for the project were obtained. Four hundred and fifty-three children were included and 54% were male. Participants were Aboriginal (92%), Torres Strait Islander (2%) or both (6%). Abnormal middle ear appearance was observed in 26 (6%) children and was significantly associated with previous ear infection (odds ratio (OR), 8.8; 95% confidence interval (CI), 3.2-24.0) and households with eight or more people (OR, 3.8; 95% CI, 1.1-14.1) in the imputed multivariable mixed-effects model. No significant associations were found for the other recognised risk factors investigated. Overcrowding should continue to be a core focus for communities and policy makers in reducing middle ear disease and its consequences in Aboriginal and Torres Strait Islander peoples.

  14. Restoration of middle-ear input in fluid-filled middle ears by controlled introduction of air or a novel air-filled implant.

    PubMed

    Ravicz, Michael E; Chien, Wade W; Rosowski, John J

    2015-10-01

    The effect of small amounts of air on sound-induced umbo velocity in an otherwise saline-filled middle ear (ME) was investigated to examine the efficacy of a novel balloon-like air-filled ME implant suitable for patients with chronically non-aerated MEs. In this study, air bubbles or air-filled implants were introduced into saline-filled human cadaveric MEs. Umbo velocity, a convenient measure of ME response, served as an indicator of hearing sensitivity. Filling the ME with saline reduced umbo velocity by 25-30 dB at low frequencies and more at high frequencies, consistent with earlier work (Ravicz et al., Hear. Res. 195: 103-130 (2004)). Small amounts of air (∼30 μl) in the otherwise saline-filled ME increased umbo velocity substantially, to levels only 10-15 dB lower than in the dry ME, in a frequency- and location-dependent manner: air in contact with the tympanic membrane (TM) increased umbo velocity at all frequencies, while air located away from the TM increased umbo velocity only below about 500 Hz. The air-filled implant also affected umbo velocity in a manner similar to an air bubble of equivalent compliance. Inserting additional implants into the ME had the same effect as increasing air volume. These results suggest these middle-ear implants would significantly reduce conductive hearing loss in patients with chronically fluid-filled MEs.

  15. Conditioning the middle ear reflex at sensation levels below reflex threshold: air jet and electrical stimulation.

    PubMed

    McDaniel-Bacon, L; Fulton, R T; Laskowski, R P

    1980-01-01

    An ABAB functional analysis, conditioning and generalization, design was used in 3 experiments (2 were formal studies and 1 was empirical in nature) to investigate the conditionability of the middle ear reflex. The conditioned stimuli were subreflex threshold pure tones of various frequencies and intensities. The unconditioned stimulus (UCS) was an auricular air jet to the contralateral ear in the first experiment and cutaneous electrical stimulation to the ipsolateral, probe ear in the last 2 experiments. Reflexes were monitored by an otoadmittance meter, storage oscilloscope, and strip chart recorder. In the first experiment (air jet UCS), no subjects met the conditioning criterion within the maximum presentation of 400 paired trials, despite pilot evidence which indicated conditioning was feasible. In the second experiment (electrical stimulation UCS), 2 subjects met conditioning criterion; however, only one subject reconditioned and demonstrated partial generalization to other conditioned stimuli. In the third experiment (electrical stimulation UCS), one of 3 subjects who had previously been unconditionable with the air jet UCS met conditioning and reconditioning criterion and demonstrated partial generalization. Results indicate that the middle ear reflex can be conditioned to be elicited by subreflex threshold pure tones, however, results are limited.

  16. Middle ear adenoma with neuroendocrine differentiation: relate of two cases and literature review

    PubMed Central

    Bittencourt, Aline Gomes; Tsuji, Robinson Koji; Cabral, Francisco; Pereira, Larissa Vilela; Fonseca, Anna Carolina de Oliveira; Alves, Venâncio; Bento, Ricardo Ferreira

    2013-01-01

    Summary Introduction: Adenomas with neuroendocrine differentiation are defined as neuroendocrine neoplasms, and they are rarely found in the head and neck. Objective: To describe two cases of a middle ear adenoma with neuroendocrine differentiation, with a literature review. Case Report: Patient 1 was a 41-year-old woman who presented with a 3-year history of left aural fullness associated with ipsilateral “hammer beating” tinnitus. Patient 2 was a 41-year-old male who presented with unilateral conductive hearing loss. Conclusion: Adenoma with neuroendocrine differentiation of the middle ear is a rare entity, but it should be considered in patients with tinnitus, aural fullness, and a retrotympanic mass and remembered as a diferential diagnosis of tympanic paraganglioma. PMID:25992031

  17. Optical and tomographic imaging of a middle ear malformation in the bullfrog (Rana catesbeiana).

    PubMed

    Horowitz, Seth S; Simmons, Andrea Megela; Ketten, Darlene R

    2005-08-01

    Using a combination of in vivo computerized tomography and histological staining, a middle ear anomaly in two wild-caught American bullfrogs (Rana catesbeiana) is characterized. In these animals, the tympanic membrane, extrastapes, and pars media (shaft) of the stapes are absent on one side of the head, with the other side exhibiting normal morphology. The pars interna (footplate) of the stapes and the operculum are present in their normal positions at the entrance of the otic capsule on both the affected and unaffected sides. The pattern of deformity suggests a partial failure of development of tympanic pathway tissues, but with a preservation of the opercularis pathway. While a definitive proximate cause of the condition could not be determined, the anomalies show similarities to developmental defects in mammalian middle ear formation. PMID:16158670

  18. Nonlinear Vibration Response Measured at Umbo and Stapes in the Rabbit Middle ear.

    PubMed

    Peacock, John; Pintelon, Rik; Dirckx, Joris

    2015-10-01

    Using laser vibrometry and a stimulation and signal analysis method based on multisines, we have measured the response and the nonlinearities in the vibration of the rabbit middle ear at the level of the umbo and the stapes. With our method, we were able to detect and quantify nonlinearities starting at sound pressure levels of 93-dB SPL. The current results show that no significant additional nonlinearity is generated as the vibration signal is passed through the middle ear chain. Nonlinearities are most prominent in the lower frequencies (125 Hz to 1 kHz), where their level is about 40 dB below the vibration response. The level of nonlinearities rises with a factor of nearly 2 as a function of sound pressure level, indicating that they may become important at very high sound pressure levels such as those used in high-power hearing aids.

  19. Optical and tomographic imaging of a middle ear malformation in the bullfrog (Rana catesbeiana).

    PubMed

    Horowitz, Seth S; Simmons, Andrea Megela; Ketten, Darlene R

    2005-08-01

    Using a combination of in vivo computerized tomography and histological staining, a middle ear anomaly in two wild-caught American bullfrogs (Rana catesbeiana) is characterized. In these animals, the tympanic membrane, extrastapes, and pars media (shaft) of the stapes are absent on one side of the head, with the other side exhibiting normal morphology. The pars interna (footplate) of the stapes and the operculum are present in their normal positions at the entrance of the otic capsule on both the affected and unaffected sides. The pattern of deformity suggests a partial failure of development of tympanic pathway tissues, but with a preservation of the opercularis pathway. While a definitive proximate cause of the condition could not be determined, the anomalies show similarities to developmental defects in mammalian middle ear formation.

  20. Optical and tomographic imaging of a middle ear malformation in the bullfrog (Rana catesbeiana)

    NASA Astrophysics Data System (ADS)

    Horowitz, Seth S.; Simmons, Andrea Megela; Ketten, Darlene R.

    2005-08-01

    Using a combination of in vivo computerized tomography and histological staining, a middle ear anomaly in two wild-caught American bullfrogs (Rana catesbeiana) is characterized. In these animals, the tympanic membrane, extrastapes, and pars media (shaft) of the stapes are absent on one side of the head, with the other side exhibiting normal morphology. The pars interna (footplate) of the stapes and the operculum are present in their normal positions at the entrance of the otic capsule on both the affected and unaffected sides. The pattern of deformity suggests a partial failure of development of tympanic pathway tissues, but with a preservation of the opercularis pathway. While a definitive proximate cause of the condition could not be determined, the anomalies show similarities to developmental defects in mammalian middle ear formation.

  1. Virus and bacteria enhance histamine production in middle ear fluids of children with acute otitis media.

    PubMed

    Chonmaitree, T; Patel, J A; Lett-Brown, M A; Uchida, T; Garofalo, R; Owen, M J; Howie, V M

    1994-06-01

    Histamine levels were measured in 677 middle ear fluid (MEF) samples from 248 children (aged 2 months to 7 years) with acute otitis media (AOM); of these, 116 (47%) had documented viral infection. Histamine content was higher in bacteria-positive than in bacteria-negative MEF samples (P = .007) and higher in samples from patients with viral infection than in those from patients with no viral infection (P = .002). Bacteria and viruses together had an additive effect on histamine content in MEF. Histamine concentration in the initial MEF sample tended to be higher in patients with persistent otitis than in those with good response to treatment (P = .14). Results suggest that viruses, bacteria, or both induce histamine production, which leads to increased inflammation in the middle ear. Antihistaminic drugs may be beneficial. Large, prospective, controlled trials of the effects of antihistamine as an adjunct therapy in bacterial and viral AOM are required before recommendations can be made.

  2. SuperSILAC Quantitative Proteome Profiling of Murine Middle Ear Epithelial Cell Remodeling with NTHi

    PubMed Central

    Val, Stéphanie; Burgett, Katelyn; Brown, Kristy J.; Preciado, Diego

    2016-01-01

    Background Chronic Otitis Media with effusion (COME) develops after sustained inflammation and is characterized by secretory middle ear epithelial metaplasia and effusion, most frequently mucoid. Non-typeable Haemophilus influenzae (NTHi), the most common acute Otitis Media (OM) pathogen, is postulated to promote middle ear epithelial remodeling in the progression of OM from acute to chronic. The goals of this study were to examine histopathological and quantitative proteomic epithelial effects of NTHi challenge in a murine middle ear epithelial cell line. Methods NTHi lysates were generated and used to stimulate murine epithelial cells (mMEEC) cultured at air-liquid interface over 48 hours– 1 week. Conditional quantitative Stable Isotope Labeling with Amino Acids in Cell Culture (SILAC) of cell lysates was performed to interrogate the global protein production in the cells, using the SuperSILAC technique. Histology of the epithelium over time was done to measure bacterial dependent remodeling. Results Mass spectrometry analysis identified 2,565 proteins across samples, of which 74 exhibited differential enrichment or depletion in cell lysates (+/-2.0 fold-change; p value<0.05). The key molecular functions regulated by NTHi lysates exposure were related to cell proliferation, death, migration, adhesion and inflammation. Finally, chronic exposure induced significant epithelial thickening of cells grown at air liquid interface. Conclusions NTHi lysates drive pathways responsible of cell remodeling in murine middle ear epithelium which likely contributes to observed epithelial hyperplasia in vitro. Further elucidation of these mediators will be critical in understanding the progression of OM from acute to chronic at the molecular level. PMID:26859300

  3. [The intraoperative monitoring of the gas pressure in the middle ear].

    PubMed

    Petrov, S M; Chernushevich, I I; Azizov, G R

    2014-01-01

    The objective of the present work was to elucidate the patterns and mechanisms underlying the changes of gas pressure in the middle ear during the operation of stapedoplasty with a view to the application of the data obtained for objective recording of the stapedial reflex at the time of surgical intervention. Ten subjects with the unaffected hearing function were recruited for the study. Tympanometry was carried out at one-minute intervals starting from the onset of feeding nitrogen monooxide till the completion of septoplasty. It was shown that the surgical intervention under inhalation anesthesia is associated with periodic rises and drops in the gas pressure in the middle ear within a range from 500 dPA to 88 dPA with a period from 5.7 to 22 minutes. It is argued that these changes can be attributed to the periodic opening of the Eustachian tube when the gas pressure reaches a certain level due to continuous diffusion of nitrogen monooxide into the middle ear (the "preventive" release of pressure) followed by the passive closure of the auditory tube. The authors propose based on the results of the study recommendations on the performance of stapedial reflexometry during the surgical intervention with the use of impedancometry.

  4. Impaired binaural hearing in children produced by a threshold level of middle ear disease.

    PubMed

    Hogan, Sarah C M; Moore, David R

    2003-06-01

    Otitis media with effusion (OME), a form of middle ear disease, is the most common reason for young children both to visit their family doctor and to have surgery. Almost all children have at least a single episode of OME before their first birthday and annual incidence rates exceed 50% in each of the first five years. For most children, OME occurs infrequently, but about 10-15% of children have OME during more than half of their first six years. Middle ear effusions attenuate and delay sound, causing conductive sound distortion during the crucial years for language acquisition. The many studies of OME effects on language and other indices of development have produced mixed results. However, a consensus is emerging of mild language impairment in the preschool years, with subsequent performance, emotional, and behavioral difficulties. In addition to the peripheral hearing loss produced directly by the disease, binaural and other central auditory deficits can outlive the OME. It has been unclear which children are at risk of central impairment following OME, since the children studied have generally been recruited from otolaryngology clinics. Consequently, a detailed prospective history of the middle ear status of participants has not been available. By studying six-year-old children with a lifetime known history of OME, we show in this study that only those children with a cumulative OME experience of more than about half the time during the first five years consistently have residual impaired binaural hearing. PMID:12943367

  5. Laser Doppler velocimetry for measurement of nonlinearity in the vibrations of the middle ear

    NASA Astrophysics Data System (ADS)

    Peacock, John; Dirckx, Joris

    2014-05-01

    At audible Frequencies and at sound pressure below 96 dB SPL the mammalian middle ear is known to behave as an almost entirely linear system. However, as we go to higher sound pressure levels, smaller nonlinear distortions begin to appear, and increase with increasing pressure level. Some modern hearing aids seek to remedy hearing impairment by amplifying sounds to sound pressure levels as high as 130 or 140 dB SPL. Thus at these levels the small nonlinear distortions can become significant, and understanding their behaviour could help us to improve the design of these hearing aids. In order to measure the tiny vibration amplitudes of the middle ear, and to detect the even smaller nonlinear distortions, a very sensitive measurement and analysis method is needed. The tiny vibration amplitudes of the middle ear can easily be measured with laser vibrometry. Thanks to the highly linear response of LDV, the technique is also able to measure small nonlinearities. To detect the nonlinear distortions we developed a sophisticated measurement and analysis method based on the use of multisine excitation signals. These signals are specially designed to measure nonlinear systems. We will describe our set up and our stimulation and analysis method in detail, we will then go on to present some results of measurements at different points along the ossicular chain.

  6. Asian Sand Dust Enhances the Inflammatory Response and Mucin Gene Expression in the Middle Ear

    PubMed Central

    Chang, Jiwon; Go, Yoon Young; Park, Moo Kyun; Chae, Sung-Won; Lee, Seon-Heui; Song, Jae-Jun

    2016-01-01

    Objectives. Asia sand dust (ASD) is known to cause various human diseases including respiratory infection. The aim of this study was to examine the effect of ASD on inflammatory response in human middle ear epithelial cells (HMEECs) in vitro and in vivo. Methods. Cell viability was assessed using the cell counting kit-8 assay. The mRNA levels of various genes including COX-2, TNF-a, MUC 5AC, MUC 5B, TP53, BAX, BCL-2, NOX4, and SOD1 were analyzed using semiquantitative realtime polymerase chain reaction. COX-2 protein levels were determined by western blot analysis. Sprague Dawley rats were used for in vivo investigations of inflammatory reactions in the middle ear epithelium as a result of ASD injection. Results. We observed dose-dependent decrease in HMEEC viability. ASD exposure significantly increased COX-2, TNF-a, MUC5AC, and MUC5B mRNA expression. Also, ASD affected the mRNA levels of apoptosis- and oxidative stress-related genes. Western blot analysis revealed a dose-dependent increase in COX-2 production. Animal studies also demonstrated an ASD-induced inflammatory response in the middle ear epithelium. Conclusion. Environmental ASD exposure can result in the development of otitis media. PMID:27095518

  7. Impaired binaural hearing in children produced by a threshold level of middle ear disease.

    PubMed

    Hogan, Sarah C M; Moore, David R

    2003-06-01

    Otitis media with effusion (OME), a form of middle ear disease, is the most common reason for young children both to visit their family doctor and to have surgery. Almost all children have at least a single episode of OME before their first birthday and annual incidence rates exceed 50% in each of the first five years. For most children, OME occurs infrequently, but about 10-15% of children have OME during more than half of their first six years. Middle ear effusions attenuate and delay sound, causing conductive sound distortion during the crucial years for language acquisition. The many studies of OME effects on language and other indices of development have produced mixed results. However, a consensus is emerging of mild language impairment in the preschool years, with subsequent performance, emotional, and behavioral difficulties. In addition to the peripheral hearing loss produced directly by the disease, binaural and other central auditory deficits can outlive the OME. It has been unclear which children are at risk of central impairment following OME, since the children studied have generally been recruited from otolaryngology clinics. Consequently, a detailed prospective history of the middle ear status of participants has not been available. By studying six-year-old children with a lifetime known history of OME, we show in this study that only those children with a cumulative OME experience of more than about half the time during the first five years consistently have residual impaired binaural hearing.

  8. Miniature, minimally invasive, tunable endoscope for investigation of the middle ear

    PubMed Central

    Pawlowski, Michal E.; Shrestha, Sebina; Park, Jesung; Applegate, Brian E.; Oghalai, John S.; Tkaczyk, Tomasz S.

    2015-01-01

    We demonstrate a miniature, tunable, minimally invasive endoscope for diagnosis of the auditory system. The probe is designed to sharply image anatomical details of the middle ear without the need for physically adjusting the position of the distal end of the endoscope. This is achieved through the addition of an electrowetted, tunable, electronically-controlled lens to the optical train. Morphological imaging is enabled by scanning light emanating from an optical coherence tomography system. System performance was demonstrated by imaging part of the ossicular chain and wall of the middle ear cavity of a normal mouse. During the experiment, we electronically moved the plane of best focus from the incudo-stapedial joint to the stapedial artery. Repositioning the object plane allowed us to image anatomical details of the middle ear beyond the depth of field of a static optical system. We also demonstrated for the first time to our best knowledge, that an optical system with an electrowetted, tunable lens may be successfully employed to measure sound-induced vibrations within the auditory system by measuring the vibratory amplitude of the tympanic membrane in a normal mouse in response to pure tone stimuli. PMID:26114043

  9. Surgical management of middle ear cholesteatoma and reconstruction at the same time

    PubMed Central

    González, Francisco; Holguín, Jorge; Guerra, Claudia

    2014-01-01

    Introduction: In the surgical management of cholesteatoma, one can opt for a closed technique (simple mastoidectomy) or open surgery (radical mastoidectomy). Open mastoidectomy with reconstruction of the posterior wall and the middle ear in a single surgery combines the advantages of both techniques, namely, adequate surgical exposure, eradication of cholesteatoma, and anatomical reconstruction of the middle ear structures. Objective: To evaluate the surgical results in the management of cholesteatoma through the technique of open mastoidectomy with reconstruction of the posterior wall and the middle ear in a single surgery. Methods: Prospective analytical observational study conducted between 2009 and 2012 with patients undergoing this surgical technique in the Hospital Universitario del Valle [University Hospital of Valle], performing preoperative clinical monitoring and quarterly postoperative tomography with previous assessments of hearing and pre- and postoperative audiometry. Results: Forty-five patients were studied. Mean postoperative follow-up was 28 months. Surgical success was achieved in 93.3% of patients, as measured by clinical and radiological follow-up. Hearing preservation was found after reconstruction of the hearing mechanism, based on measured audiometry, i.e., pure-tone average (PTA), using the statistical test for paired samples between preoperative and postoperative PTA. (95%CI -1.47-12.15). Residual cholesteatoma was present in 6.6% of cases; three to four times lower than the rate reported in the literature. Conclusions: This type of surgery can be considered a successful technique in the treatment of cholesteatoma in selected cases. PMID:25386039

  10. The value of otoendoscopy in the management of middle ear cholesteatoma

    PubMed Central

    Abtahi, Sayed Hamidreza; Abootalebian, Farzaneh; Rogha, Mehrdad; Berjis, Nezamoddin

    2015-01-01

    Background: The surgical management of cholesteatoma is a controversial issue, particularly regarding intact-canal-wall mastoidectomy (ICWM) versus canal-wall-down mastoidectomy (CWDM). The current experiment compared the quality of visualization in different middle ear structures using ICWM with otoendoscopy with findings of CWDM by microscopy. Materials and Methods: The patients diagnosed with cholesteatoma underwent tympanomastoidectomy, and then the patients selected for CWDM were included in the study (25 patients: 11 females and 14 males). After removing the cholesteatoma from the involved areas, otoendoscopic examination was done with a 4 mm, 0° endoscope by a neurootologist. All five middle ear structures (lateral epitympanum, sinus tympani, posterior crus of the stapes, round window niche, and Eustachian tube orifice) suspected of occult cholesteatoma were evaluated in terms of having or lacking the pathology. Then, CWDM was performed and all of the mentioned sites were reevaluated for diagnosing occult cholesteatoma. Results: The symmetric measures were 73%, 92%, 63%, 81%, and 100% for lateral epitympanum, sinus tympani, posterior crus of the stapes, round window niche, and Eustachian tube orifice, respectively. Conclusion: Otoendoscopy was confirmed to have a great potential to be adopted by surgeons as a less invasive procedure in the surgical management of middle ear cholesteatoma. PMID:26958054

  11. [A quantitative study of the presence of interleukin-1 and interleukin-6 in cholesteatoma of the middle ear].

    PubMed

    Aumente, P O; Bujía, J; Kim, C; Jiménez Giménez, J; López Villarejo, P

    1996-01-01

    Cholesteatoma of the middle ear is an inflammatory disease characterized by the presence of a keratinized squamous layer that leads to bone destruction. The process may be mediated by various factors (interleukins) produced by an activated macrophages and keratinocytes. Interleukin-1 (IL-1) and interleukin-6 (IL-6) concentrations were measured in extracts of cholesteatoma and normal tissue using the enzyme immunoassay technique (ELISA) after protein concentrations were determined. IL-1 alpha and IL-6 had higher concentrations in cholesteatoma than in normal skin and played a prominent role in bone resorption.

  12. Vibrant SoundBridge application to middle ear windows versus conventional hearing aids: a comparative study based on international outcome inventory for hearing aids.

    PubMed

    Atas, Ahmet; Tutar, Hakan; Gunduz, Bulent; Bayazıt, Yıldırım A

    2014-01-01

    In this study, we aimed to compare the outcomes of satisfaction of the patients who used hearing aids preceding the vibrant sound bridge (VSB) application on middle ear windows (14 oval window and 5 round window). Nineteen adult patients with conductive or mixed hearing loss were included in the study. All patients used behind the ear hearing aids on the site which was selected for VSB application. The patients used hearing aids for at least 3 months before the VSB operation. The floating mass transducer (FMT) was placed on one of the middle ear windows (oval or round) in VSB operation. The patients were evaluated with International Outcome Inventory for Hearing Aids (IOI-HA) preoperatively after at least 3 months trial of conventional hearing aid and postoperatively after 3 months use of VSB. No perioperative problem was encountered. The total score of IOI-HA was significantly higher with VSB compared with conventional hearing aids (p < 0.05). No statistically significant difference was found between the daily use, residual activity limitations, satisfaction, impact on others, quality of life between middle ear implant and hearing aid (p > 0.05). The IOI-HA scores were significantly higher with the middle ear implant than the conventional hearing aid regarding benefit and residual participation restrictions (p < 0.05). Although the scores for quality of life assessment was similar between VSB and hearing aid use, there was a superiority of VSB in terms of benefit and residual participation restrictions as well as overall IOI-HA scores as the FMT was placed on one of the middle ear windows.

  13. Correlative mRNA and protein expression of middle and inner ear inflammatory cytokines during mouse acute otitis media.

    PubMed

    Trune, Dennis R; Kempton, Beth; Hausman, Frances A; Larrain, Barbara E; MacArthur, Carol J

    2015-08-01

    Although the inner ear has long been reported to be susceptible to middle ear disease, little is known of the inflammatory mechanisms that might cause permanent sensorineural hearing loss. Recent studies have shown inner ear tissues are capable of expressing inflammatory cytokines during otitis media. However, little quantitative information is available concerning cytokine gene expression in the inner ear and the protein products that result. Therefore, this study was conducted of mouse middle and inner ear during acute otitis media to measure the relationship between inflammatory cytokine genes and their protein products with quantitative RT-PCR and ELISA, respectively. Balb/c mice were inoculated transtympanically with heat-killed Haemophilus influenzae and middle and inner ear tissues collected for either quantitative RT-PCR microarrays or ELISA multiplex arrays. mRNA for several cytokine genes was significantly increased in both the middle and inner ear at 6 h. In the inner ear, these included MIP-2 (448 fold), IL-6 (126 fold), IL-1β (7.8 fold), IL-10 (10.7 fold), TNFα (1.8 fold), and IL-1α (1.5 fold). The 24 h samples showed a similar pattern of gene expression, although generally at lower levels. In parallel, the ELISA showed the related cytokines were present in the inner ear at concentrations higher by 2-122 fold higher at 18 h, declining slightly from there at 24 h. Immunohistochemistry with antibodies to a number of these cytokines demonstrated they occurred in greater amounts in the inner ear tissues. These findings demonstrate considerable inflammatory gene expression and gene products in the inner ear following acute otitis media. These higher cytokine levels suggest one potential mechanism for the permanent hearing loss seen in some cases of acute and chronic otitis media.

  14. High-resolution computed tomography of the middle ear and mastoid. Part I. Normal radioanatomy including normal variations

    SciTech Connect

    Swartz, J.D.

    1983-08-01

    The use of high-resolution computed tomography (CT) to examine the middle ear and mastoid is discussed. Exceptional detail of the viscera of the middle ear was attained in almost all cooperative patients with proper technique. Important anatomical structures are illustrated and discussed, and the appropriate projection for depicting specific structures is emphasized. Normal variations, preoperative knowledge of which is important to the otologic surgeon, are also illustrated.

  15. High-resolution computed tomography of the middle ear and mastoid. Part III. Surgically altered anatomy and pathology

    SciTech Connect

    Swartz, J.D.; Goodman, R.S.; Russell, K.B.; Ladenheim, S.F.; Wolfson, R.J.

    1983-08-01

    High-resolution computed tomography (CT) provides an excellent method for examination of the surgically altered middle ear and mastoid. Closed-cavity and open-cavity types of mastoidectomy are illustrated. Recurrent cholesteatoma in the mastoid bowl is easily diagnosed. Different types of tympanoplasty are discussed and illustrated, as are tympanostomy tubes and various ossicular reconstructive procedures. Baseline high-resolution CT of the postoperative middle ear and mastoid is recommended at approximately 3 months following the surgical procedure.

  16. The ototoxic effect of boric acid solutions applied into the middle ear of guinea pigs.

    PubMed

    Oztürkcan, Sedat; Dündar, Riza; Katilmis, Hüseyin; Ilknur, Ali Ekber; Aktaş, Sinem; Haciömeroğlu, Senem

    2009-05-01

    This study analyzed the ototoxic effects of boric acid solutions. Boric acid solutions have been used as otologic preparations for many years. Boric acid is commonly found in solutions prepared with alcohol or distilled water but can also be found in a powder form. These preparations are used for both their antiseptic and acidic qualities in external and middle ear infections. We investigated the ototoxic effect of boric acid solutions on guinea pigs. We are unaware of any similar, previously published study of this subject in English. The study was conducted on 28 young albino guinea pigs. Prior to application of the boric acid solution under general anesthesia, an Auditory Brainstem Response (ABRs) test was applied to the right ear of the guinea pigs. Following the test, a perforation was created on the tympanic membrane of the right ear of each guinea pig and small gelfoam pieces were inserted into the perforated area. Test solutions were administered to the middle ear for 10 days by means of a transcanal route. Fifteen days after inserting the gelfoams in all of the guinea pigs, we anasthesized the guinea pigs and removed the gelfoams from the perforated region of the ear and then performed an ABRs on each guinea pig. The ABRs were within the normal range before the applications. After the application, no significant changes were detected in the ABRs thresholds in neither the saline group nor the group administered boric acid and distilled water solution; however, significant changes were detected in the ABRs thresholds of the Gentamicine and boric acid and alcohol solution groups. We believe that a 4% boric acid solution prepared with distilled water can be a more reliable preparation than a 4% boric acid solution prepared with alcohol.

  17. Middle ear squamous papilloma: A report of four cases analyzed by HPV and EBV in situ hybridization

    PubMed Central

    ZHOU, HAN; CHEN, ZHIBIN; ZHANG, WEIMING; XING, GUANGQIAN

    2014-01-01

    Squamous papilloma involving the middle ear as a primary lesion is an extremely rare occurrence. The aims of the present study were to investigate the presence of human papilloma virus (HPV) and Epstein-Barr virus (EBV) infections in primary middle ear squamous papilloma and to describe the clinical and pathological features of the disease along with therapeutic strategies. A retrospective review was conducted of four patients with clinical and pathological diagnoses of middle ear squamous papilloma. In situ hybridization (ISH) for a wide range of HPV DNA subtypes and EBV-encoded RNA was performed in the tissue samples obtained from these patients. Only two cases of primary squamous papilloma in the middle ear have been previously reported in the English literature. These papillomas developed in males of ~60-years of age and otorrhea was the most frequent complaint. Premalignant changes were observed in two of the present cases and ISH of HPV and EBV was negative in all four cases. The results of the present study indicated that chronic inflammatory stimulation, not HPV and EBV infection, is involved in the occurrence of middle ear squamous papilloma and its malignant transformation. Radical surgery and long-term postoperative follow-up are recommended due to its malignant and recurrent potential. Further genetic investigations with additional new cases are required to clarify the pathogenesis of squamous papilloma involving the middle ear. PMID:24348817

  18. Experimental study of vibrations of gerbil tympanic membrane with closed middle ear cavity.

    PubMed

    Maftoon, Nima; Funnell, W Robert J; Daniel, Sam J; Decraemer, Willem F

    2013-08-01

    The purpose of the present work is to investigate the spatial vibration pattern of the gerbil tympanic membrane (TM) as a function of frequency. In vivo vibration measurements were done at several locations on the pars flaccida and pars tensa, and along the manubrium, on surgically exposed gerbil TMs with closed middle ear cavities. A laser Doppler vibrometer was used to measure motions in response to audio frequency sine sweeps in the ear canal. Data are presented for two different pars flaccida conditions: naturally flat and retracted into the middle ear cavity. Resonance of the flat pars flaccida causes a minimum and a shallow maximum in the displacement magnitude of the manubrium and pars tensa at low frequencies. Compared with a flat pars flaccida, a retracted pars flaccida has much lower displacement magnitudes at low frequencies and does not affect the responses of the other points. All manubrial and pars tensa points show a broad resonance in the range of 1.6 to 2 kHz. Above this resonance, the displacement magnitudes of manubrial points, including the umbo, roll off with substantial irregularities. The manubrial points show an increasing displacement magnitude from the lateral process toward the umbo. Above 5 kHz, phase differences between points along the manubrium start to become more evident, which may indicate flexing of the tip of the manubrium or a change in the vibration mode of the malleus. At low frequencies, points on the posterior side of the pars tensa tend to show larger displacements than those on the anterior side. The simple low-frequency vibration pattern of the pars tensa becomes more complex at higher frequencies, with the breakup occurring at between 1.8 and 2.8 kHz. These observations will be important for the development and validation of middle ear finite-element models for the gerbil.

  19. Otitis media in the Tgif knockout mouse implicates TGFβ signalling in chronic middle ear inflammatory disease.

    PubMed

    Tateossian, Hilda; Morse, Susan; Parker, Andrew; Mburu, Philomena; Warr, Nick; Acevedo-Arozena, Abraham; Cheeseman, Michael; Wells, Sara; Brown, Steve D M

    2013-07-01

    Otitis media with effusion (OME) is the most common cause of hearing loss in children and tympanostomy to alleviate the condition remains the commonest surgical intervention in children in the developed world. Chronic and recurrent forms of OM are known to have a very significant genetic component, however, until recently little was known of the underlying genes involved. The identification of mouse models of chronic OM has indicated a role of transforming growth factor beta (TGFβ) signalling and its impact on responses to hypoxia in the inflamed middle ear. We have, therefore, investigated the role of TGFβ signalling and identified and characterized a new model of chronic OM carrying a mutation in the gene for transforming growth interacting factor 1 (Tgif1). Tgif1 homozygous mutant mice have significantly raised auditory thresholds due to a conductive deafness arising from a chronic effusion starting at around 3 weeks of age. The OM is accompanied by a significant thickening of the middle ear mucosa lining, expansion of mucin-secreting goblet cell populations and raised levels of vascular endothelial growth factor, TNF-α and IL-1β in ear fluids. We also identified downstream effects on TGFβ signalling in middle ear epithelia at the time of development of chronic OM. Both phosphorylated SMAD2 and p21 levels were lowered in the homozygous mutant, demonstrating a suppression of the TGFβ pathway. The identification and characterization of the Tgif mutant supports the role of TGFβ signalling in the development of chronic OM and provides an important candidate gene for genetic studies in the human population.

  20. Otitis media in the Tgif knockout mouse implicates TGFβ signalling in chronic middle ear inflammatory disease

    PubMed Central

    Tateossian, Hilda; Morse, Susan; Parker, Andrew; Mburu, Philomena; Warr, Nick; Acevedo-Arozena, Abraham; Cheeseman, Michael; Wells, Sara; Brown, Steve D.M.

    2013-01-01

    Otitis media with effusion (OME) is the most common cause of hearing loss in children and tympanostomy to alleviate the condition remains the commonest surgical intervention in children in the developed world. Chronic and recurrent forms of OM are known to have a very significant genetic component, however, until recently little was known of the underlying genes involved. The identification of mouse models of chronic OM has indicated a role of transforming growth factor beta (TGFβ) signalling and its impact on responses to hypoxia in the inflamed middle ear. We have, therefore, investigated the role of TGFβ signalling and identified and characterized a new model of chronic OM carrying a mutation in the gene for transforming growth interacting factor 1 (Tgif1). Tgif1 homozygous mutant mice have significantly raised auditory thresholds due to a conductive deafness arising from a chronic effusion starting at around 3 weeks of age. The OM is accompanied by a significant thickening of the middle ear mucosa lining, expansion of mucin-secreting goblet cell populations and raised levels of vascular endothelial growth factor, TNF-α and IL-1β in ear fluids. We also identified downstream effects on TGFβ signalling in middle ear epithelia at the time of development of chronic OM. Both phosphorylated SMAD2 and p21 levels were lowered in the homozygous mutant, demonstrating a suppression of the TGFβ pathway. The identification and characterization of the Tgif mutant supports the role of TGFβ signalling in the development of chronic OM and provides an important candidate gene for genetic studies in the human population. PMID:23459932

  1. Experimental study of vibrations of gerbil tympanic membrane with closed middle ear cavity.

    PubMed

    Maftoon, Nima; Funnell, W Robert J; Daniel, Sam J; Decraemer, Willem F

    2013-08-01

    The purpose of the present work is to investigate the spatial vibration pattern of the gerbil tympanic membrane (TM) as a function of frequency. In vivo vibration measurements were done at several locations on the pars flaccida and pars tensa, and along the manubrium, on surgically exposed gerbil TMs with closed middle ear cavities. A laser Doppler vibrometer was used to measure motions in response to audio frequency sine sweeps in the ear canal. Data are presented for two different pars flaccida conditions: naturally flat and retracted into the middle ear cavity. Resonance of the flat pars flaccida causes a minimum and a shallow maximum in the displacement magnitude of the manubrium and pars tensa at low frequencies. Compared with a flat pars flaccida, a retracted pars flaccida has much lower displacement magnitudes at low frequencies and does not affect the responses of the other points. All manubrial and pars tensa points show a broad resonance in the range of 1.6 to 2 kHz. Above this resonance, the displacement magnitudes of manubrial points, including the umbo, roll off with substantial irregularities. The manubrial points show an increasing displacement magnitude from the lateral process toward the umbo. Above 5 kHz, phase differences between points along the manubrium start to become more evident, which may indicate flexing of the tip of the manubrium or a change in the vibration mode of the malleus. At low frequencies, points on the posterior side of the pars tensa tend to show larger displacements than those on the anterior side. The simple low-frequency vibration pattern of the pars tensa becomes more complex at higher frequencies, with the breakup occurring at between 1.8 and 2.8 kHz. These observations will be important for the development and validation of middle ear finite-element models for the gerbil. PMID:23624883

  2. Attenuated TLRs in middle ear mucosa contributes to susceptibility of chronic suppurative otitis media.

    PubMed

    Si, Yu; Zhang, Zhi Gang; Chen, Sui Jun; Zheng, Yi Qing; Chen, Yu Bin; Liu, Yi; Jiang, Huaili; Feng, Lian Qiang; Huang, Xi

    2014-08-01

    The variability in the recovery of otitis media (OM) is not well understood. Recent data have shown a critical role for toll-like receptors (TLRs) in inflammatory responses to bacteria. It remains unclear whether TLRs-mediated mucosal immunity plays a role in the OM recovery. The etiology, pathological profile, expression levels of TLR2, TLR4, TLR5, TLR9 and proinflammatory cytokines were measured in human middle-ear mucosae sampled from three subject groups: non-OM group, chronic otitis-media (COM) group, and chronic suppurative otitis-media (CSOM) group. Of the 72 ears, 86.11% CSOM patients were positive for bacteria. The cellular makeup of the middle ear mucosa differs among the three groups. Mucosae from the CSOM group presented chronic inflammation or suppurative inflammation in the rudimentary stroma, mainly with infiltration of monocytes and macrophages. The mRNA and protein levels of TLR2, TLR4, and TLR5 exhibited no difference between the non-OM and COM groups but were significantly lower in the CSOM group. Conversely, there was no significant difference in the TLR9 level among the three groups. Furthermore, proinflammatory cytokines TNF-α, IL-1β, IFN-γ, IL-6 were up-regulated in the CSOM group. This study provides evidence that the variability in clinical otitis media recovery might be associated with the variability in the expression of mucosal TLRs. Reduced TLR levels in the middle-ear mucosa might cause weak host response to bacteria, persistent inflammation and susceptibility to CSOM. PMID:24882571

  3. External and middle ear sound pressure distribution and acoustic coupling to the tympanic membrane

    PubMed Central

    Bergevin, Christopher; Olson, Elizabeth S.

    2014-01-01

    Sound energy is conveyed to the inner ear by the diaphanous, cone-shaped tympanic membrane (TM). The TM moves in a complex manner and transmits sound signals to the inner ear with high fidelity, pressure gain, and a short delay. Miniaturized sensors allowing high spatial resolution in small spaces and sensitivity to high frequencies were used to explore how pressure drives the TM. Salient findings are: (1) A substantial pressure drop exists across the TM, and varies in frequency from ∼10 to 30 dB. It thus appears reasonable to approximate the drive to the TM as being defined solely by the pressure in the ear canal (EC) close to the TM. (2) Within the middle ear cavity (MEC), spatial variations in sound pressure could vary by more than 20 dB, and the MEC pressure at certain locations/frequencies was as large as in the EC. (3) Spatial variations in pressure along the TM surface on the EC-side were typically less than 5 dB up to 50 kHz. Larger surface variations were observed on the MEC-side. PMID:24606269

  4. External and middle ear sound pressure distribution and acoustic coupling to the tympanic membrane.

    PubMed

    Bergevin, Christopher; Olson, Elizabeth S

    2014-03-01

    Sound energy is conveyed to the inner ear by the diaphanous, cone-shaped tympanic membrane (TM). The TM moves in a complex manner and transmits sound signals to the inner ear with high fidelity, pressure gain, and a short delay. Miniaturized sensors allowing high spatial resolution in small spaces and sensitivity to high frequencies were used to explore how pressure drives the TM. Salient findings are: (1) A substantial pressure drop exists across the TM, and varies in frequency from ∼10 to 30 dB. It thus appears reasonable to approximate the drive to the TM as being defined solely by the pressure in the ear canal (EC) close to the TM. (2) Within the middle ear cavity (MEC), spatial variations in sound pressure could vary by more than 20 dB, and the MEC pressure at certain locations/frequencies was as large as in the EC. (3) Spatial variations in pressure along the TM surface on the EC-side were typically less than 5 dB up to 50 kHz. Larger surface variations were observed on the MEC-side.

  5. The influence of the mechanical behaviour of the middle ear ligaments: a finite element analysis.

    PubMed

    Gentil, F; Parente, M; Martins, P; Garbe, C; Jorge, R N; Ferreira, A; Tavares, João Manuel R S

    2011-01-01

    The interest in computer modelling of biomechanical systems, mainly by using the finite element method (FEM), has been increasing, in particular for analysis of the mechanical behaviour of the human ear. In this work, a finite element model of the middle ear was developed to study the dynamic structural response to harmonic vibrations for distinct sound pressure levels applied on the eardrum. The model includes different ligaments and muscle tendons with elastic and hyperelastic behaviour for these supportive structures. Additionally, the nonlinear behaviour of the ligaments and muscle tendons was investigated, as they are the connection between ossicles by contact formulation. Harmonic responses of the umbo and stapes footplate displacements, between 100 Hz and 10 kHz, were obtained and compared with previously published work. The stress state of ligaments (superior, lateral, and anterior of malleus and superior and posterior of incus) was analysed, with the focus on balance of the supportive structures of the middle ear, as ligaments make the link between the ossicular chain and the walls of the tympanic cavity. The results obtained in this work highlight the importance of using hyperelastic models to simulate the mechanical behaviour for the ligaments and tendons.

  6. Development of a surgical instrument for measuring forces applied to the ossicles of the middle ear.

    PubMed

    Sheedy, Michael; Bergin, Mike; Wylie, Grant; Ross, Peter; Dove, Richard; Bird, Phil

    2012-12-01

    Surgery of the middle ear is a delicate process that requires the surgeon to manipulate the ossicles, the smallest bones in the body. Excessive force applied to the ossicles can easily be transmitted through to the inner ear which may cause a permanent sensorineural hearing loss. An instrument was required to measure the forces applied to cadaveric temporal bone ossicles with the vision of measuring forces in vivo at a later stage. A feasibility study was conducted to investigate a method of measuring force and torque applied to the ossicles of the middle ear. Information from research papers was gathered to determine the expected amplitudes. The study looked at commercially available transducers as well as constructing an instrument using individual axis transducers coupled together. A prototype surgical instrument was constructed using the ATI industrial automation Nano17 six axis transducer. The Nano17 allows for the measurement of force and torque in the X, Y and Z axis to a resolution of 1/320 N. The use of the Nano17 enabled rapid development of the surgical instrument. It meets the requirements for its use on cadaveric models and has the potential to be a useful data collection tool in vivo.

  7. Quantitative analysis of interleukin-1-alpha gene expression in middle ear cholesteatoma.

    PubMed

    Bujía, J; Kim, C; Boyle, D; Hammer, C; Firestein, G; Kastenbauer, E

    1996-02-01

    Regardless of its origin, cholesteatoma is characterized by the presence of a keratinizing epithelium with an hyperproliferative behavior leading to a very important bone resorption. Previous studies have demonstrated overexpression of interleukin-1 (IL-1 protein in middle ear cholesteatoma by immunohistochemistry and enzyme-linked immunosorbent assay, suggesting a significant role for IL-1-alpha. In this study, the presence of IL-1-alpha messenger ribonucleic acid (mRNA) was quantified by in situ hybridization on frozen sections (n = 10) and by computer-assisted image analysis. Human skin obtained from the external ear canal (n = 10) was used as the control. A higher percentage of cells hybridized for the antisense probes IL-1-alpha mRNA was found in cholesteatoma epithelium. Furthermore, keratinocytes of the suprabasal cell layers were also found to contain specific hybridizations. Some cells in cholesteatoma stroma also contained IL-1-alpha mRNA transcripts. The results of this study confirm the central role of IL-1-alpha in the epithelium hyperproliferation and bone resorption observed in middle ear cholesteatoma.

  8. The role of pars flaccida in human middle ear sound transmission.

    PubMed

    Aritomo, H; Goode, R L; Gonzalez, J

    1988-04-01

    The role of the pars flaccida in middle ear sound transmission was studied with the use of twelve otoscopically normal, fresh, human temporal bones. Peak-to-peak umbo displacement in response to a constant sound pressure level at the tympanic membrane was measured with a noncontacting video measuring system capable of repeatable measurements down to 0.2 micron. Measurements were made before and after pars flaccida modifications at 18 frequencies between 100 and 4000 Hz. Four pars flaccida modifications were studied: (1) acoustic insulation of the pars flaccida to the ear canal with a silicone rubber baffle, (2) stiffening the pars flaccida with cyanoacrylate cement, (3) decreasing the tension of the pars flaccida with a nonperforating incision, and (4) perforation of the pars flaccida. All of the modifications (except the perforation) had a minimal effect on umbo displacement; this seems to imply that the pars flaccida has a minor acoustic role in human beings. PMID:3132684

  9. Cochlear implantation in chronic otitis media and previous middle ear surgery: 20 years of experience.

    PubMed

    Vincenti, V; Pasanisi, E; Bacciu, A; Bacciu, S; Zini, C

    2014-08-01

    Cochlear implantation in the setting of chronic otitis media or previous middle ear surgery poses several problems for the surgeon: possible spread of infection to the cochlea and the subarachnoid spaces with consequent meningitis, risk of electrode array extrusion and possible recurrence of the original disease. Several surgical strategies have been proposed to overcome these problems. In the present study, clinical and functional results of cochlear implantation in 26 patients with chronic otitis media (8 cases) or previous middle ear surgery (18 cases) in the ear most suitable for implantation were retrospectively reviewed. Among the 8 patients with chronic otitis media, in 7 cases a subtotal petrosectomy associated with external auditory canal closure and mastoid and Eustachian tube obliteration was performed, while in the remaining patient cochlear implantation was done 6 months after a myringoplasty. The only complication observed was a reperforation of the tympanic membrane in this latter patient. Among the 18 patients with previous middle ear surgery, 2 had undergone intact canal wall tympanomastoidectomy and were implanted utilising the previous surgical approach. In the remaining 16 patients who had a radical cavity, an open technique was maintained in 3 cases; a cavity revision associated to external auditory canal closure, Eustachian tube and mastoid obliteration was performed in 12 patients, while in one case a middle cranial fossa approach was utilised. Two of the 3 patients in whom an open technique was maintained have experienced electrode array extrusion. The only complication observed in the remaining patients was the breakdown of the external auditory canal closure in one case. No problems were noted in patients who had undergone intact canal wall tympanomastoidectomy as well as in the subject implanted via the middle cranial fossa approach. All patients achieved and maintained good hearing performance over time. Subtotal petrosectomy associated

  10. Phase 3 Trials of Thermosensitive Ciprofloxacin Gel for Middle Ear Effusion in Children with Tubes

    PubMed Central

    Park, Albert H.; White, David R.; Moss, Jonathan R.; Bear, Moraye; LeBel, Carl

    2016-01-01

    Objective To investigate the efficacy, safety, and microbiology of a thermosensitive otic suspension of ciprofloxacin (OTO-201) in children with bilateral middle ear effusion undergoing tympanostomy tube placement. Study Design Two randomized, double-blind, sham-controlled phase 3 trials. Patients were randomized to intratympanic OTO-201 or sham. Setting Children with bilateral middle ear effusion undergoing tympanostomy tube placement. Subjects/Methods Studies evaluated 532 patients (6 months to 17 years old) in a combined analysis of efficacy (treatment failure: presence of otorrhea, otic or systemic antibiotic use, lost to follow-up, missed visits), safety (audiometry, otoscopy, tympanometry), and microbiology. Results There was a lower cumulative proportion of treatment failures in patients receiving OTO-201 vs tympanostomy tubes alone (1) on days 4, 8, 15, and 29; (2) on day 15, primary end point (23.0% vs 45.1%; age-adjusted odds ratio, 0.341; P < .001; reduction in relative risk, 49%); and (3) on day 15, blinded-assessor otorrhea treatment failure (7.0% vs 19.4%; age-adjusted odds ratio, 0.303; P < .001; reduction in relative risk, 64%). Per-protocol and subgroup analyses (baseline demographics, pathogen type, culture status, effusion type, microbiologic response) supported these findings. There were no drug-related serious adverse events; the most frequent treatment-emergent adverse events in both groups were pyrexia, postoperative pain, nasopharyngitis, cough, and upper respiratory tract infection. OTO-201 administration had no evidence of increased tube occlusion and no negative effect on audiometry, tympanometry, or otoscopy. Conclusions Combined analysis of 2 phase 3 trials demonstrated a lower cumulative proportion of treatment failures through day 15 compared with TT alone when OTO-201 was administered intratympanically for otitis media with bilateral middle ear effusion at time of tympanostomy tube placement. PMID:27188702

  11. In Vitro Interaction of Pseudomonas aeruginosa with Human Middle Ear Epithelial Cells

    PubMed Central

    Mittal, Rahul; Grati, M’hamed; Gerring, Robert; Blackwelder, Patricia; Yan, Denise; Li, Jian-Dong; Liu, Xue Zhong

    2014-01-01

    Background Otitis media (OM) is an inflammation of the middle ear which can be acute or chronic. Acute OM is caused by Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis whereas Pseudomonas aeruginosa is a leading cause of chronic suppurative otitis media (CSOM). CSOM is a chronic inflammatory disorder of the middle ear characterized by infection and discharge. The survivors often suffer from hearing loss and neurological sequelae. However, no information is available regarding the interaction of P. aeruginosa with human middle ear epithelial cells (HMEECs). Methodology and Findings In the present investigation, we demonstrate that P. aeruginosa is able to enter and survive inside HMEECs via an uptake mechanism that is dependent on microtubule and actin microfilaments. The actin microfilament disrupting agent as well as microtubule inhibitors exhibited significant decrease in invasion of HMEECs by P. aeruginosa. Confocal microscopy demonstrated F-actin condensation associated with bacterial entry. This recruitment of F-actin was transient and returned to normal distribution after bacterial internalization. Scanning electron microscopy demonstrated the presence of bacteria on the surface of HMEECs, and transmission electron microscopy confirmed the internalization of P. aeruginosa located in the plasma membrane-bound vacuoles. We observed a significant decrease in cell invasion of OprF mutant compared to the wild-type strain. P. aeruginosa induced cytotoxicity, as demonstrated by the determination of lactate dehydrogenase levels in culture supernatants of infected HMEECs and by a fluorescent dye-based assay. Interestingly, OprF mutant showed little cell damage compared to wild-type P. aeruginosa. Conclusions and Significance This study deciphered the key events in the interaction of P. aeruginosa with HMEECs in vitro and highlighted the role of bacterial outer membrane protein, OprF, in this process. Understanding the molecular mechanisms in

  12. Otoacoustic emissions from insect ears: evidence of active hearing?

    PubMed

    Kössl, Manfred; Möckel, Doreen; Weber, Melanie; Seyfarth, Ernst-August

    2008-07-01

    Sensitive hearing organs often employ nonlinear mechanical sound processing which generates distortion-product otoacoustic emissions (DPOAE). Such emissions are also recordable from tympanal organs of insects. In vertebrates (including humans), otoacoustic emissions are considered by-products of active sound amplification through specialized sensory receptor cells in the inner ear. Force generated by these cells primarily augments the displacement amplitude of the basilar membrane and thus increases auditory sensitivity. As in vertebrates, the emissions from insect ears are based on nonlinear mechanical properties of the sense organ. Apparently, to achieve maximum sensitivity, convergent evolutionary principles have been realized in the micromechanics of these hearing organs-although vertebrates and insects possess quite different types of receptor cells in their ears. Just as in vertebrates, otoacoustic emissions from insects ears are vulnerable and depend on an intact metabolism, but so far in tympanal organs, it is not clear if auditory nonlinearity is achieved by active motility of the sensory neurons or if passive cellular characteristics cause the nonlinear behavior. In the antennal ears of flies and mosquitoes, however, active vibrations of the flagellum have been demonstrated. Our review concentrates on experiments studying the tympanal organs of grasshoppers and moths; we show that their otoacoustic emissions are produced in a frequency-specific way and can be modified by electrical stimulation of the sensory cells. Even the simple ears of notodontid moths produce distinct emissions, although they have just one auditory neuron. At present it is still uncertain, both in vertebrates and in insects, if the nonlinear amplification so essential for sensitive sound processing is primarily due to motility of the somata of specialized sensory cells or to active movement of their (stereo-)cilia. We anticipate that further experiments with the relatively simple ears

  13. Proteomic Characterization of Middle Ear Fluid Confirms Neutrophil Extracellular Traps as a Predominant Innate Immune Response in Chronic Otitis Media

    PubMed Central

    Val, Stephanie; Poley, Marian; Brown, Kristy; Choi, Rachel; Jeong, Stephanie; Colberg-Poley, Annie; Rose, Mary C.; Panchapakesan, Karuna C.; Devaney, Joe C.; Perez-Losada, Marcos

    2016-01-01

    Background Chronic Otitis Media (COM) is characterized by middle ear effusion (MEE) and conductive hearing loss. MEE reflect mucus hypersecretion, but global proteomic profiling of the mucosal components are limited. Objective This study aimed at characterizing the proteome of MEEs from children with COM with the goal of elucidating important innate immune responses. Method MEEs were collected from children (n = 49) with COM undergoing myringotomy. Mass spectrometry was employed for proteomic profiling in nine samples. Independent samples were further analyzed by cytokine multiplex assay, immunoblotting, neutrophil elastase activity, next generation DNA sequencing, and/or immunofluorescence analysis. Results 109 unique and common proteins were identified by MS. A majority were innate immune molecules, along with typically intracellular proteins such as histones and actin. 19.5% percent of all mapped peptide counts were from proteins known to be released by neutrophils. Immunofluorescence and immunoblotting demonstrated the presence of neutrophil extracellular traps (NETs) in every MEE, along with MUC5B colocalization. DNA found in effusions revealed unfragmented DNA of human origin. Conclusion Proteomic analysis of MEEs revealed a predominantly neutrophilic innate mucosal response in which MUC5B is associated with NET DNA. NETs are a primary macromolecular constituent of human COM middle ear effusions. PMID:27078692

  14. Anomalous Facial Nerve: An Unusual Cause of Obstruction of Middle Ear Ventilation.

    PubMed

    Das, S; Tuli, I P

    2015-01-01

    Numerous anomalies and variations of facial nerve anatomy leading to iatrogenic injury are described. However, there are no reports of facial nerve dehiscence near its second genu causing a hump and obstructing middle ear ventilation pathway, as found in our case. This particular anomaly of facial nerve is being reported to highlight its uniqueness and that a dehiscent facial nerve may be a rare but dangerous cause of obstruction of the attic ventilation. One has to be aware of this unusual anomaly to prevent inadvertent damage to the facial nerve while clearing aditus block in persistent otitis media. PMID:26620754

  15. Feasibility of spectral-domain phase-sensitive optical coherence tomography for middle ear vibrometry.

    PubMed

    Subhash, Hrebesh M; Nguyen-Huynh, Anh; Wang, Ruikang K; Jacques, Steven L; Choudhury, Niloy; Nuttall, Alfred L

    2012-06-01

    We describe a novel application of spectral-domain phase-sensitive optical coherence tomography (SD PS-OCT) to detect the tiny motions of the middle ear structures, such as the tympanic membrane and ossicular chain, and their morphological features for differential diagnosis of CHL. This technique has the potential to provide meaningful vibration of ossicles with a vibration sensitivity of ≈ 0.5 nm at 1 kHz of acoustic stimulation. To the best of our knowledge, this is the first demonstration of depth-resolved vibration imaging of ossicles with a PS-OCT system at a nanometer scale.

  16. Role of the middle ear muscle apparatus in mechanisms of speech signal discrimination

    NASA Technical Reports Server (NTRS)

    Moroz, B. S.; Bazarov, V. G.; Sachenko, S. V.

    1980-01-01

    A method of impedance reflexometry was used to examine 101 students with hearing impairment in order to clarify the interrelation between speech discrimination and the state of the middle ear muscles. Ability to discriminate speech signals depends to some extent on the functional state of intraaural muscles. Speech discrimination was greatly impaired in the absence of stapedial muscle acoustic reflex, in the presence of low thresholds of stimulation and in very small values of reflex amplitude increase. Discrimination was not impeded in positive AR, high values of relative thresholds and normal increase of reflex amplitude in response to speech signals with augmenting intensity.

  17. Middle ear capillary haemangioma: Review of literature and appraisal of management options.

    PubMed

    Salamat, Ali A; Casselden, Elizabeth; Theaker, Jeffrey; Batty, Vincent; Thomas, Sebastian

    2016-12-01

    Infantile middle ear capillary haemangiomas (MECH) are a rare entity with only five reported cases in the literature. At present there is no consensus regarding the management of such lesions. Extra-cutaneous haemangiomas have been successfully managed with oral propranolol but not yet reported in MECH. We present a further case and appraise the management options. At present oral propranolol has not been used in the treatment of MECH. The literature suggests that infantile MECH have a higher propensity to spontaneously involute and a greater likelihood of response to propranolol. Surgical excision is the best option in older children and adults.

  18. Congenital malformations of the external and middle ear: high-resolution CT findings of surgical import

    SciTech Connect

    Swartz, J.D.; Faerber, E.N.

    1985-03-01

    The external auditory canal, middle ear, and bulk of the ossicular chain develop from the first branchial groove, first and second branchial arches, and first pharyngeal pouch. Embryologic development of these structures is complex and only rarely are two anomalies identical. This study includes 11 cases of unilateral external auditory canal atresia and two cases of bilateral atresia. Eight cases (four bilateral) of isolated congenital ossicular anomalies are also included. Emphasis is placed on findings of surgical import. All patients were studied with computed tomography only, because it was believed that the bony and soft-tissue detail achieved is superior to that with conventional multidirectional tomography.

  19. Optimising μCT imaging of the middle and inner cat ear.

    PubMed

    Seifert, H; Röher, U; Staszyk, C; Angrisani, N; Dziuba, D; Meyer-Lindenberg, A

    2012-04-01

    This study's aim was to determine the optimal scan parameters for imaging the middle and inner ear of the cat with micro-computertomography (μCT). Besides, the study set out to assess whether adequate image quality can be obtained to use μCT in diagnostics and research on cat ears. For optimisation, μCT imaging of two cat skull preparations was performed using 36 different scanning protocols. The μCT-scans were evaluated by four experienced experts with regard to the image quality and detail detectability. By compiling a ranking of the results, the best possible scan parameters could be determined. From a third cat's skull, a μCT-scan, using these optimised scan parameters, and a comparative clinical CT-scan were acquired. Afterwards, histological specimens of the ears were produced which were compared to the μCT-images. The comparison shows that the osseous structures are depicted in detail. Although soft tissues cannot be differentiated, the osseous structures serve as valuable spatial orientation of relevant nerves and muscles. Clinical CT can depict many anatomical structures which can also be seen on μCT-images, but these appear a lot less sharp and also less detailed than with μCT.

  20. The use of radiology in middle ear and temporal bone surgery.

    PubMed

    Bagger-Sjöbäck, Dan; Papatziamos, Georgios

    2010-01-01

    A nationwide survey was performed in Sweden regarding the way that practicing otosurgeons utilize radiological imaging before and after performing surgery of the middle ear and temporal bone. Sixty-six surgeons from 30 different otorhinolaryngology departments participated in the study. These represented all hospitals in Sweden where ear surgery is performed to some degree. A questionnaire was designed consisting of 18 questions that were assigned to 4 different groups. Questions in group 1 assessed the general conditions regarding imaging services in the local hospital. Questions in group 2 illuminated the level of tuition and competence development when it comes to judging radiological examinations. Group 3 questions mirrored the clinical routines when ordering various specific investigations. In group 4, the questions were aimed at describing which type of information the surgeons wanted to obtain from the imaging investigations. The answers gave a good picture of how Swedish otosurgeons use the services offered by their local radiological departments. One of the conclusions is that, although there is consensus regarding certain types of examinations in specific conditions, there is a great variation in how surgeons utilize radiological imaging in many of the most common clinical conditions. It is obvious that the routines regarding the use of radiology in conjunction with ear surgery vary from place to place and also between different surgeons. Whether a consensus can be reached in the future regarding this issue remains to be seen. PMID:20714202

  1. Determinants of sensorineural hearing loss in chronic middle-ear disease.

    PubMed

    Kasliwal, Neeraj; Joshi, Sanjeev; Pareek, S M

    2004-10-01

    A statistical study was carried out on SNHL in CSOM. The study group consisted of 1,828 patients suffering from CSOM who underwent surgery at our centre from 1982 to 2001, out of these 510 cases with unilateral CSOM were selected for this study by a strict selection criteria so as to eliminate covariables such as exposure to acoustic trauma, head injury, previous ear surgery and hereditary causes. The healthy ear served as control. We determined the average SNHL in relation to the age of onset, duration of disease, examining it in relation to other eventual aural complications such as cholesteatoma, ossicular chain erosion und otorrhea.On the basis of data obtained we observed consistent co-relation between severity of SNHL and duration of the disease, presence of cholesteatoma, ossicular erosion, attic and subtotal perforations. These findings suggest that more severe middle ear disease may result in SNHL and thus early intervention in cases of chronic suppurative Otitis media is desired. PMID:23120094

  2. [Histological evaluation of the condition of the trepanation cavity coating after radical surgery on the middle ear].

    PubMed

    Anikin, I A; Bykova, V P; Patiakina, O K; Portenko, E G

    1998-01-01

    Tissue samples obtained intraoperatively from different parts of the middle ear in the course of the radical operation (35 cases) or reconstructive operations in patients with the history of surgical intervention on the ear (67 cases) were examined histologically. Fibrous-atrophic changes in the trepanation cavity coating correlated with the duration of the disease and the time since the radical operation. Pathomorphological and topographic profile of the changes in the operated ear coating copies relevant picture of otitis media purulenta chronica. The tympanomastoid cavity coating was characterized by increasing fibrous-atrophic changes reflecting regeneratory-plastic insufficiency of the epithelium and persistent tympanofibrosis in conditions of open trepanation cavity with disturbed anatomic relations in the middle ear.

  3. Morphologic changes in the inner ear of Chinchilla laniger after middle ear administration of gentamicin in a sustained-release vehicle.

    PubMed

    Hoffer, M E; Balough, B J; Kopke, R D; Henderson, J; DeCicco, M; Wester, D C; O'Leary, M J; Balaban, C

    1999-05-01

    The use of transtympanic gentamicin has become a popular method of treating Meniere's disease; nevertheless, many questions still remain regarding this therapy. Until investigators can control the exact amount of medicine that is administered to the ear and have an understanding of the kinetics of gentamicin, therapy will continue to rely on empirical data. Previously we described the use of a fibrin-based sustained-release vehicle impregnated with gentamicin in the middle ears of chinchillas. With this model a kinetics curve of gentamicin was defined. The inner ears of these animals were submitted for immunohistochemical and histologic analysis. We discuss the ultrastructural changes seen and correlate this to our kinetics data. We also examine measurement of hair cell damage with heat shock protein levels. By better understanding the actions of gentamicin in this animal model, we hope to facilitate safer use of intratympanic medicines in our patient population. PMID:10229587

  4. Diagnostic Performance of Endoscopic and Microscopic Procedures for Identifying Different Middle Ear Structures and Remaining Disease in Patients with Chronic Otitis Media: A Prospective Cohort Study

    PubMed Central

    Farahani, Farhad; Shariatpanahi, Elnaz; Jahanshahi, Javane; Poorolajal, Jalal

    2015-01-01

    Background The diagnostic performance of endoscopic and microscopic procedures for detecting diseases of the middle ear in patients with chronic otitis media (COM) has rarely been investigated. This study was conducted to compare the performance of these procedures for identifying middle ear structures and their associated diseases in COM patients. Methods In this prospective cohort study, 58 patients with chronic COM, who were candidates for tympanoplasty with or without a mastoidectomy, were enrolled. Before the surgical intervention, the middle ear was examined via an operating microscope and then through an endoscope to identify the middle ear structures as well as diseases associated with the middle ear. Results The patients were 15 years of age or older. The anatomical parts of the middle ear – the epitympanic, posterior mesotympanic, and hypotympanic structures – were more visible through an endoscope than through a microscope. In addition, the various segments of the mesotympanum, oval window, round window, and Eustachian tube were more visible via endoscopy. The post-operative endoscopic reevaluation of the middle ear revealed that a cholesteatoma had remained in four of 13 patients after surgery. Conclusion According to the results of this study, in cases in which there is poor visibility with the operating microscope or the surgeon suspects remaining disease within the middle ear, endoscopy could be utilized to improve the evaluation of more hidden middle ear pits and structures, particularly if there is a potentially recrudescent pathology. PMID:26167935

  5. Ear Infections

    MedlinePlus

    ... affects the middle ear and is called otitis media. The tubes inside the ears become clogged with fluid and mucus. This can affect hearing, because sound cannot get through all that fluid. If your child isn't old enough to say "My ear ...

  6. Phospholipids in middle ear effusion and serum analysed by liquid ionization mass spectrometry

    NASA Astrophysics Data System (ADS)

    Yokoyama, Yukio; Hashimoto, Masaki; Tsuchiya, Masahiko; Yabe, Rie

    1991-12-01

    Phospholipids in middle ear effusion (MEE) and serum were analysed by liquid ionization (LI) mass spectrometry. The LI mass spectra of MEE and serum measured directly without preliminary separation commonly exhibited several unknown peaks such as those at m/z 520 and 577. These peaks were also observed in 90% ethanol fractions of MEE. The mass spectrum of the 90% ethanol fraction of serum exhibited dominant peaks at m/z 551, 577 and 603 (with mass differences of 26) and also at m/z 520. Comparing this spectrum with the mass spectra of standard compounds, the ions of mass 551, 577 and 603 were identified to be [M -- phosphocholine]+ of dipalmitoyl, palmitoyl-oleoyl and dioleoyl-glycero-3- phosphocholine (PC), respectively. The relative abundances of these ions observed in serum were qualitatively consistent with the composition of the fatty acid residue of PCs in serum determined by gas chromatography. The ions of mass 520, observed to be more abundant in MEE than in serum, were also identified to be [ceramide+ -- O], which is equal in mass to [M -- phosphocholine]+, of N-palmitoyl-sphingo-phosphocholine (Sph). The results strongly suggest that a part of blood permeates into the middle ear cavity, and especially Sph does this easily. LI mass spectrometry is useful for analysis of phospholipids in biological samples.

  7. Dosimetric analysis of the use of CBCT in diagnostic radiology: sinus and middle ear.

    PubMed

    Dierckx, D; Saldarriaga Vargas, C; Rogge, F; Lichtherte, S; Struelens, L

    2015-01-01

    The use of cone beam computed tomography (CBCT) in diagnostic radiology departments is increasing. Several discussions arise whether with the CBCT application, some multi-slice CT (MSCT) examinations can be replaced by it. High hopes are set regarding the dosimetric aspects of CBCT: are patient doses in between those of conventional X-rays and MSCT? In this study, effective dose and organ doses were evaluated for two non-dental CBCT examinations: sinus and middle ear. A comparison with the dose obtained with a MSCT protocol was performed. Moreover, the sinus examination was also compared with the dose obtained by projection radiography (RX). Effective doses were estimated from thermoluminescent detector dose measurements in an anthropomorphic phantom and were compared against Monte Carlo simulations. Results show that the effective dose for the sinus examination is more than three times higher with MSCT than with CBCT and about five times lower with RX compared with CBCT, whereas for the middle ear examination, the effective dose obtained with MSCT is almost six times higher than that of CBCT. Finally, a sensitivity study on the size and position of the CBCT field of view showed the influence of these two factors on the dose received by the patient.

  8. Middle Ear Myoclonus: Two Informative Cases and a Systematic Discussion of Myogenic Tinnitus

    PubMed Central

    Ellenstein, Aviva; Yusuf, Nadia; Hallett, Mark

    2013-01-01

    Background The term middle ear myoclonus (MEM) has been invoked to explain symptoms of tinnitus presumably caused by the dysfunctional movement of either of the two muscles that insert in the middle ear: tensor tympani and stapedius. MEM has been characterized through heterogeneous case reports in the otolaryngology literature, where clinical presentation is variable, phenomenology is scarcely described, the pathogenic muscle is usually not specified, natural history is unknown, and the presumptive definitive treatment, tensor tympani or stapedius tendon lysis, is inconsistently effective. It is not surprising that no unique acoustogenic mechanism or pathophysiologic process has been identified to explain MEM, one of several descriptive diagnoses associated with the complicated disorders of myogenic tinnitus. Methods Here, we explore MEM from the neurologist’s perspective. Following the detailed descriptions of two informative cases from our clinic, we systematically evaluate the different mechanisms and movement disorder phenomena that could lead to a diagnosis of MEM. Results From a functional neuroanatomic perspective, we explain how tensor tympani MEM is best explained as a form of peritubal myogenic tinnitus, similar to the related disorder of essential palatal tremor. From a pathogenic perspective, we discuss how MEM symptomatology may reflect different mechanical and neurologic processes. We emphasize the diagnostic imperative to recognize when myogenic tinnitus is consistent with a psychogenic origin. Discussion Both individual patient care and further elucidation of MEM will rely on more detailed clinical characterization as well as multidisciplinary input from neurology, otolaryngology, and dentistry. PMID:23610741

  9. Contribution of the incudo-malleolar joint to middle-ear sound transmission.

    PubMed

    Gerig, Rahel; Ihrle, Sebastian; Röösli, Christof; Dalbert, Adrian; Dobrev, Ivo; Pfiffner, Flurin; Eiber, Albrecht; Huber, Alexander M; Sim, Jae Hoon

    2015-09-01

    The malleus and incus in the human middle ear are linked by the incudo-malleolar joint (IMJ). The mobility of the human IMJ under physiologically relevant acoustic stimulation and its functional role in middle-ear sound transmission are still debated. In this study, spatial stapes motions were measured during acoustic stimulation (0.25-8 kHz) in six fresh human temporal bones for two conditions of the IMJ: (1) normal IMJ and (2) IMJ with experimentally-reduced mobility. Stapes velocity was measured at multiple points on the footplate using a scanning laser Doppler vibrometry (SLDV) system, and the 3D motion components were calculated under both conditions of the IMJ. The artificial reduction of the IMJ mobility was confirmed by measuring the relative motion between the malleus and the incus. The magnitudes of the piston-like motion of the stapes increased with the reduced IMJ mobility above 2 kHz. The increase was frequency dependent and was prominent from 2 to 4 kHz and at 5.5 kHz. The magnitude ratios of the rocking-like motions to the piston-like motion were similar for both IMJ conditions. The frequency-dependent change of the piston-like motion after the reduction of the IMJ mobility suggests that the IMJ is mobile under physiologically relevant levels of acoustic stimulation, especially at frequencies above 2 kHz.

  10. Stapes Vibration in the Chinchilla Middle Ear: Relation to Behavioral and Auditory-Nerve Thresholds.

    PubMed

    Robles, Luis; Temchin, Andrei N; Fan, Yun-Hui; Ruggero, Mario A

    2015-08-01

    The vibratory responses to tones of the stapes and incus were measured in the middle ears of deeply anesthetized chinchillas using a wide-band acoustic-stimulus system and a laser velocimeter coupled to a microscope. With the laser beam at an angle of about 40 ° relative to the axis of stapes piston-like motion, the sensitivity-vs.-frequency curves of vibrations at the head of the stapes and the incus lenticular process were very similar to each other but larger, in the range 15-30 kHz, than the vibrations of the incus just peripheral to the pedicle. With the laser beam aligned with the axis of piston-like stapes motion, vibrations of the incus just peripheral to its pedicle were very similar to the vibrations of the lenticular process or the stapes head measured at the 40 ° angle. Thus, the pedicle prevents transmission to the stapes of components of incus vibration not aligned with the axis of stapes piston-like motion. The mean magnitude curve of stapes velocities is fairly flat over a wide frequency range, with a mean value of about 0.19 mm(.)(s Pa(-1)), has a high-frequency cutoff of 25 kHz (measured at -3 dB re the mean value), and decreases with a slope of about -60 dB/octave at higher frequencies. According to our measurements, the chinchilla middle ear transmits acoustic signals into the cochlea at frequencies exceeding both the bandwidth of responses of auditory-nerve fibers and the upper cutoff of hearing. The phase lags of stapes velocity relative to ear-canal pressure increase approximately linearly, with slopes equivalent to pure delays of about 57-76 μs. PMID:26068200

  11. Evaluation of concordance between the microorganisms detected in the nasopharynx and middle ear of children with otitis media.

    PubMed

    van Dongen, Thijs M A; van der Heijden, Geert J M G; van Zon, Alice; Bogaert, Debby; Sanders, Elisabeth A M; Schilder, Anne G M

    2013-05-01

    Studies of microorganisms involved in otitis media in children often use a nasopharyngeal sample as a proxy for the middle ear fluid to test for bacteria and viruses. The question is whether such studies provide an accurate estimate of the prevalence of microorganisms involved in otitis media. We performed a systematic review of the literature reporting on the concordance between test results of nasopharyngeal and middle ear fluid samples for the most prevalent microorganisms in children with otitis media. Our findings show that the concordances vary from 68% to 97% per microorganism. For the most prevalent microbes, positive predictive values are around 50%. Most negative predictive values are moderate to high, with a range from 68% up to 97%. These results indicate that test results from nasopharyngeal samples do not always provide an accurate proxy for those of the middle ear fluid. It is important to interpret and use results of such studies carefully.

  12. Otitis externa associated with aquatic activities (swimmer's ear).

    PubMed

    Strauss, M B; Dierker, R L

    1987-01-01

    Infections of the ear canal may vary in terms of severity. Their frequency and morbidity qualify them as significant aquatic problems. The aquatic environment adds the conditional variable of moisture to the ear canal. Usually bacteria are introduced with the moisture and in the warm environment of the canal multiply, generate debris, invade the canal lining, and generate the symptoms of otitis externa. Fortunately, the incidence of this condition can be minimized by eliminating moisture in the canal. In situations where excessive moisture is likely to be introduced such as in swimmers, scuba divers, and deep sea divers the prophylactic measures of desiccation and acidification of the canal should be used. They are very effective. In the saturation diver, ear canal infections are not likely to resolve without interruption of diving activities. Individuals who have recurring ear canal infections require evaluation by an ear specialist to identify possible remedial problems that can trigger infection. Correction of anatomical problems or underlying dermatoses can prevent recurrences of OE.

  13. Comparison of advanced optical imaging techniques with current otolaryngology diagnostics for improved middle ear assessment (Conference Presentation)

    NASA Astrophysics Data System (ADS)

    Nolan, Ryan M.; Shelton, Ryan L.; Monroy, Guillermo L.; Spillman, Darold R.; Novak, Michael A.; Boppart, Stephen A.

    2016-02-01

    Otolaryngologists utilize a variety of diagnostic techniques to assess middle ear health. Tympanometry, audiometry, and otoacoustic emissions examine the mobility of the tympanic membrane (eardrum) and ossicles using ear canal pressure and auditory tone delivery and detection. Laser Doppler vibrometry provides non-contact vibrational measurement, and acoustic reflectometry is used to assess middle ear effusion using sonar. These technologies and techniques have advanced the field beyond the use of the standard otoscope, a simple tissue magnifier, yet the need for direct visualization of middle ear disease for superior detection, assessment, and management remains. In this study, we evaluated the use of portable optical coherence tomography (OCT) and pneumatic low-coherence interferometry (LCI) systems with handheld probe delivery to standard tympanometry, audiometry, otoacoustic emissions, laser Doppler vibrometry, and acoustic reflectometry. Comparison of these advanced optical imaging techniques and current diagnostics was conducted with a case study subject with a history of unilateral eardrum trauma. OCT and pneumatic LCI provide novel dynamic spatiotemporal structural data of the middle ear, such as the thickness of the eardrum and quantitative detection of underlying disease pathology, which could allow for more accurate diagnosis and more appropriate management than currently possible.

  14. [The influence of dead lymphocytes from middle ear secretion on the development of sensorineural hearing impairment associated with acute otitis media].

    PubMed

    Yashan, A I; Khoruzhiĭ, I V

    2015-01-01

    The objective of the present work was to estimate the number of lymphocytes in the middle ear secretion that had died as a result of apoptosis or necrosis in the patients presenting with acute otitis media and to elucidate the relationship between this phenomenon and the development of sensorineural impairment of hearing. The study included a total of 106 patients suffering from acute middle otitis allocated two groups. Group 1 was comprised of 75 (70.8%) patients with hearing loss of the conductive type alone while group 2 contained 31 (29.2%) patients with the combined type of hearing loss. The contents of the tympanic cavity was obtained by means of tympanic puncture, the lymphocytes isolated from middle ear secretion were studied with the use of a flow cytometer in order to determine the number of dead cells. In the patients of group 1, 15.2±0.6% and 10.6±0.5% of all lymphocytes underwent apoptosis and necrosis respectively. In the patients of group, lymphocyte apoptosis was observed in 24.7±1.% of the cases (p<0.05) and necrosis in 14.0±0.5% ones (p<0.05). It was shown that liberation of intracellular proteolytic enzymes and cytokines taking place largely in the course of necrosis activates phagocytosis, stimulates the inflammatory reaction, and thereby promotes resolution of the pathological processes in the middle ear due to the prevention of their extension into the labyrinth.

  15. Otorrhagia as the initial presentation of an internal carotid artery aneurysm in the middle ear. Case presentation

    PubMed Central

    PETRI, MARIA; DINESCU, VERONICA; NECULA, VIOLETA; COSGAREA, MARCEL

    2016-01-01

    Middle ear aneurysms are rare and difficult to treat. The case of a 50-year-old female who presented with left otorrhagia caused by an internal carotid aneurysm is reported. She had no medical history of tinnitus, vertigo, otalgia or otorrhea. Middle ear surgery was effective in resolving bleeding and did not cause any permanent neurological deficit. High resolution computed tomography angiography is the technique of choice and, in some cases, can be complemented with a magnetic resonance angiography. Misdiagnosis of the internal carotid artery aneurysm may lead to serious morbidity because of bleeding or vascular occlusion. The use of modern imaging techniques explain the current relative increase in frequency. PMID:27152084

  16. COMPARISON BETWEEN COMPUTED TOMOGRAPHIC CHARACTERISTICS OF THE MIDDLE EAR IN NONBRACHYCEPHALIC AND BRACHYCEPHALIC DOGS WITH OBSTRUCTIVE AIRWAY SYNDROME.

    PubMed

    Salgüero, Raquel; Herrtage, Michael; Holmes, Mark; Mannion, Paddy; Ladlow, Jane

    2016-01-01

    Prevalence of subclinical middle ear lesions in dogs that undergo computed tomography (CT) and magnetic resonance imaging of the head has been reported up to 41%. A predisposition in brachycephalics has been suggested, however evidence-based studies are lacking. Aims of this retrospective cross-sectional study were to compare CT characteristics of the middle ear in groups of nonbrachycephalic and brachycephalic dogs that underwent CT of the head for conditions unrelated to ear disease, and test associations between thickness of the soft palate and presence of subclinical middle ear lesions. One observer recorded CT findings for each dog without knowledge of group status. A total of 65 dogs met inclusion criteria (25 brachycephalic, 40 nonbrachycephalic). Brachycephalic dogs had a significantly thicker bulla wall (P = 2.38 × 10(-26)) and smaller luminal volume (P = 5.74 × 10(-20)), when compared to nonbrachycephalic dogs. Soft palate thickness was significantly greater in the brachycephalic group (P = 2.76 × 10(-9)). Nine of 25 brachycephalic dogs had material in the lumen of the tympanic cavity, compared to zero of 45 of nonbrachycephalics. Within the brachycephalic group, a significant difference in mean soft palate thickness was identified for dogs with material in the middle ear (12.2 mm) vs. air-filled bullae (9 mm; P = 0.016). Findings from the current study supported previous theories that brachycephalic dogs have a greater prevalence of subclinical middle ear effusion and smaller bulla luminal size than nonbrachycephalic dogs. Authors recommend that the bulla lumen volume formula previously developed for mesaticephalic dogs, (-0.612 + 0.757 [lnBW]) be adjusted to 1/3(-0.612 + 0.757 [lnBW]) for brachycephalic breeds. PMID:26765680

  17. Synergistic effect of interleukin 1 alpha on nontypeable Haemophilus influenzae-induced up-regulation of human beta-defensin 2 in middle ear epithelial cells

    PubMed Central

    Moon, Sung-Kyun; Lee, Haa-Yung; Pan, Huiqi; Takeshita, Tamotsu; Park, Raekil; Cha, Kiweon; Andalibi, Ali; Lim, David J

    2006-01-01

    Background We recently showed that beta-defensins have antimicrobial activity against nontypeable Haemophilus influenzae (NTHi) and that interleukin 1 alpha (IL-1 alpha) up-regulates the transcription of beta-defensin 2 (DEFB4 according to new nomenclature of the Human Genome Organization) in human middle ear epithelial cells via a Src-dependent Raf-MEK1/2-ERK signaling pathway. Based on these observations, we investigated if human middle ear epithelial cells could release IL-1 alpha upon exposure to a lysate of NTHi and if this cytokine could have a synergistic effect on beta-defensin 2 up-regulation by the bacterial components. Methods The studies described herein were carried out using epithelial cell lines as well as a murine model of acute otitis media (OM). Human cytokine macroarray analysis was performed to detect the released cytokines in response to NTHi exposure. Real time quantitative PCR was done to compare the induction of IL-1 alpha or beta-defensin 2 mRNAs and to identify the signaling pathways involved. Direct activation of the beta-defensin 2 promoter was monitored using a beta-defensin 2 promoter-Luciferase construct. An IL-1 alpha blocking antibody was used to demonstrate the direct involvement of this cytokine on DEFB4 induction. Results Middle ear epithelial cells released IL-1 alpha when stimulated by NTHi components and this cytokine acted in an autocrine/paracrine synergistic manner with NTHi to up-regulate beta-defensin 2. This synergistic effect of IL-1 alpha on NTHi-induced beta-defensin 2 up-regulation appeared to be mediated by the p38 MAP kinase pathway. Conclusion We demonstrate that IL-1 alpha is secreted by middle ear epithelial cells upon exposure to NTHi components and that it can synergistically act with certain of these molecules to up-regulate beta-defensin 2 via the p38 MAP kinase pathway. PMID:16433908

  18. The complex evolutionary history of the tympanic middle ear in frogs and toads (Anura)

    PubMed Central

    Pereyra, Martín O.; Womack, Molly C.; Barrionuevo, J. Sebastián; Blotto, Boris L.; Baldo, Diego; Targino, Mariane; Ospina-Sarria, Jhon Jairo; Guayasamin, Juan M.; Coloma, Luis A.; Hoke, Kim L.; Grant, Taran; Faivovich, Julián

    2016-01-01

    Most anurans possess a tympanic middle ear (TME) that transmits sound waves to the inner ear; however, numerous species lack some or all TME components. To understand the evolution of these structures, we undertook a comprehensive assessment of their occurrence across anurans and performed ancestral character state reconstructions. Our analysis indicates that the TME was completely lost at least 38 independent times in Anura. The inferred evolutionary history of the TME is exceptionally complex in true toads (Bufonidae), where it was lost in the most recent common ancestor, preceding a radiation of >150 earless species. Following that initial loss, independent regains of some or all TME structures were inferred within two minor clades and in a radiation of >400 species. The reappearance of the TME in the latter clade was followed by at least 10 losses of the entire TME. The many losses and gains of the TME in anurans is unparalleled among tetrapods. Our results show that anurans, and especially bufonid toads, are an excellent model to study the behavioural correlates of earlessness, extratympanic sound pathways, and the genetic and developmental mechanisms that underlie the morphogenesis of TME structures. PMID:27677839

  19. Histological study of the external, middle and inner ear of horses.

    PubMed

    Blanke, A; Aupperle, H; Seeger, J; Kubick, C; Schusser, G F

    2015-12-01

    Clinical, anatomical and histological aspects of the equine acoustic organ have been poorly investigated and illustrated in literature so far. It is understood that an intact acoustic organ and hearing function are of vital importance for the well-being of flight animals like horses. The knowledge of the acoustic organ is usually transferred analogously from other mammals to horses. The purpose of this study was to provide a detailed and complete histological description of the healthy equine auditory organ, and to determine its congruity to other mammalians. Anatomical dissections and histological preparations were carried out on ten cadaver heads. Specimens of various parts of the equine acoustic organ were taken and evaluated histologically. The histological composition of external, middle and inner ear structures are predominantly congruent to those of other mammals, especially to human beings. Unique inwardly directed rete pegs within the osseous ear canal and the prominent tensor tympani muscle are described for the first time. Results obtained in this study can be employed as references for further research on the equine acoustic organ and improve the understanding of the clinical development of hearing loss, otitis externa/media/interna or tympanosclerosis. PMID:25283481

  20. [Embryonal rhabdomyosarcoma of the middle ear: description of a case with long-term survival].

    PubMed

    Artesi, L; Sbrocca, M

    1990-01-01

    A case is described of embryonal rhabdomyosarcoma (E.R.) of the middle ear in a 4-year-old child; survival has been over 9 years. R.E. is the most common malignant tumor of the auricular region in children and is most often fatal due to locoregional extensions or secondary metastases carried through the bloodstream and lymphatic systems. The basis for treatment is a multidisciplinary approach to the disease: surgery with as broad an exeresis as possible; radiotherapy with tumor-killing doses of 5,500/6,000 rads; and polychemotherapy (Vincristina, Endoxan, Methotrexate). Such "aggressive" treatment often results in a high rate of morbidity with complications involving the blood, bones, eyes and meninx often requiring temporary suspension of treatment and prolonged hospitalization. PMID:2260443

  1. Feedback characteristics between implantable microphone and transducer in middle ear cavity.

    PubMed

    Arman Woo, S H; Woo, Seong Tak; Song, Byung Seop; Cho, Jin-Ho

    2013-10-01

    With the advent of implantable hearing aids, implementation and acoustic sensing strategy of the implantable microphone becomes an important issue; among the many types of implantable microphone, placing the microphone in middle ear cavity (MEC) has advantages including simple operation and insensitive to skin touching or chewing motion. In this paper, an implantable microphone was implemented and researched feedback characteristic when both the implantable microphone and the transducer were placed in the MEC. Analytical and finite element analysis were conducted to design the microphone to have a natural frequency of 7 kHz and showed good characteristics of SNR and sensitivity. For the feedback test, simple analytical and finite element analysis were calculated and compared with in vitro experiments (n = 4). From the experiments, the open-loop gain and feedback factor were measured and the minimum gain margin measured as 14.3 dB.

  2. Enhanced epithelial proliferation due to elevated levels of interleukin-1 receptors in middle ear cholesteatomas.

    PubMed

    Bujia, J; Kim, C; Ostos-Aumente, P; Lopez-Villarejo, J; Kastenbauer, E

    1997-01-01

    Middle ear cholesteatoma epithelium is a rich source of interleukin-1-alpha (IL-1-alpha), being involved in both keratinocyte hyperproliferation and bone destruction. IL-1-alpha exerts its effects by binding to two distinct IL-1 receptors (IL-1-R). In this study, we have examined the expression of IL-1-R type II (IL-1-R-II) in cholesteatoma samples and have quantified these levels with computer-assisted image analysis. Normal aural skin was used as control. Immunostaining demonstrated the presence of IL-1-R-II in both epidermis and cholesteatoma keratinocytes. The receptors were 3 times higher than those in normal epidermis. The presence of IL-1-alpha in cholesteatoma epithelium coupled with the induced expression of IL-1-R-II indicates the existence of a highly regulated system of autocrine stimulation of cholesteatoma keratinocytes by IL-1.

  3. Primary tumors of the external and middle ear. Benign and malignant glandular neoplasms.

    PubMed

    Dehner, L P; Chen, K T

    1980-01-01

    Glandular neoplasms represented 14% of primary tumors of the external and middle ear at the University of Minnesota. Although the collective term "ceruminoma" has been used in the past, four distinctive histopathologic patterns were recognized among our 12 cases: adenoma (four cases), pleomorphic adenoma (one case), adenoid cystic carcinoma (two cases) and adenocarcinoma (five cases). The prognosis correlated with these subgroups. A thorough review of the English literature also tended to support the rationale for the subclassification of so-called ceruminomas. The prevailing histogenetic view is that these tumors are derived from the modified apocrine glands of the auditory canal, the ceruminous glands. In some instances, these tumors may originate from ectopic salivary gland tissue.

  4. Comparative anatomy of the middle ear ossicles of extant hominids--Introducing a geometric morphometric protocol.

    PubMed

    Stoessel, Alexander; Gunz, Philipp; David, Romain; Spoor, Fred

    2016-02-01

    The presence of three interconnected auditory ossicles in the middle ear is a defining characteristic of mammals, and aspects of ossicle morphology are related to hearing sensitivity. However, analysis and comparison of ossicles are complicated by their minute size and complex three-dimensional shapes. Here we introduce a geometric morphometric measurement protocol for 3D shape analysis based on landmarks and semilandmarks obtained from μCT images and apply it to ossicles of extant hominids (great apes and humans). We show that the protocol is reliable and reproducible over a range of voxel resolutions, and captures even subtle shape differences. Using this approach it is possible to distinguish the hominid taxa by mean shapes of their malleus and incus (p < 0.01). The stapes appears less diagnostic, although this may in part be related to the small sample size available. Using ancestral state estimation, we show that, within hominids, Homo sapiens is derived with respect to its malleus (short manubrium, long corpus, head anterior-posterior flattened, articular facet shape), incus (wide intercrural curvature, long incudal processes, articular facet shape) and stapes (high stapes with kidney-shaped footplate). H. sapiens also shows a number of plesiomorphic shape traits whereas Gorilla and Pan possess a number of autapomorphic characteristics. The Pongo ossicles appear to be close to the plesiomorphic hominid condition. The malleus shows little difference in size among hominids, and allometry is thus of little importance. In contrast, the incus and stapes are more variable in size, and their shape is more strongly related to size differences. Although the form-function relationships in the middle ear are not fully understood, some aspects of ossicle morphology suggest that interspecific differences in hearing capacities are present among hominids. Finally, the results of this study provide a comparative framework for morphometric studies analyzing ossicles of

  5. Synergistic Effect of Dermatophagoides farinae and Lipopolysaccharides in Human Middle ear Epithelial Cells

    PubMed Central

    Lee, Ji-Eun; Kim, Yeon Hoo; Rhee, Chae-Seo

    2016-01-01

    Purpose Although the concept of "one airway, one disease," which includes the middle ear space as part of the united airway is well recognized, the role of allergens in otitis media with effusion (OME) is not clearly understood. We aimed to investigate the effect of the interaction between Dermatophagoides farinae (Der f) and lipopolysaccharide (LPS) on the induction of epithelial inflammatory response in vitro. Methods Primary human middle ear epithelial cells were exposed to Der f, LPS, or both in different sequences, and the magnitude of the immunologic responses was compared. The mRNA expressiona of mucin (MUC) 4, 5AC, 5B, 8, GM-CSF, TNF-α, TLR4, and MD-2 were evaluated using real-time PCR. MUC levels before and after siRNA-mediated knockout of TLR4 and MD-2 were assessed. Lastly, the involved cell signaling pathway was evaluated. Results The expressiona of cytokines, and the MUC 4, 5AC, 5B, and 8 genes were augmented by pretreatment with Der f followed by LPS; however, reverse treatment or combined treatment did not induce the same magnitude of response. Increased MUC expression was decreased by TLR4 knockdown, but not by MD-2 knockdown. The signal intensity of MUC 8 was higher in MD-2 over-expressed cells than in those exposed to LPS only. The translocation of nuclear factor-κB was observed in cells pretreated with Der f followed by LPS. Conclusions When Der f treatment preceded LPS exposure, Der f and LPS acted synergistically in the induction of pro-inflammatory cytokines and the MUC gene, suggesting an important role in the development of OME in patients with concealed allergy airway sensitization. PMID:27334783

  6. Predominant Bacteria Detected from the Middle Ear Fluid of Children Experiencing Otitis Media: A Systematic Review

    PubMed Central

    Ngo, Chinh C.; Massa, Helen M.; Thornton, Ruth B.; Cripps, Allan W.

    2016-01-01

    Background Otitis media (OM) is amongst the most common childhood diseases and is associated with multiple microbial pathogens within the middle ear. Global and temporal monitoring of predominant bacterial pathogens is important to inform new treatment strategies, vaccine development and to monitor the impact of vaccine implementation to improve progress toward global OM prevention. Methods A systematic review of published reports of microbiology of acute otitis media (AOM) and otitis media with effusion (OME) from January, 1970 to August 2014, was performed using PubMed databases. Results This review confirmed that Streptococcus pneumoniae and Haemophilus influenzae, remain the predominant bacterial pathogens, with S. pneumoniae the predominant bacterium in the majority reports from AOM patients. In contrast, H. influenzae was the predominant bacterium for patients experiencing chronic OME, recurrent AOM and AOM with treatment failure. This result was consistent, even where improved detection sensitivity from the use of polymerase chain reaction (PCR) rather than bacterial culture was conducted. On average, PCR analyses increased the frequency of detection of S. pneumoniae and H. influenzae 3.2 fold compared to culture, whilst Moraxella catarrhalis was 4.5 times more frequently identified by PCR. Molecular methods can also improve monitoring of regional changes in the serotypes and identification frequency of S. pneumoniae and H. influenzae over time or after vaccine implementation, such as after introduction of the 7-valent pneumococcal conjugate vaccine. Conclusions Globally, S. pneumoniae and H. influenzae remain the predominant otopathogens associated with OM as identified through bacterial culture; however, molecular methods continue to improve the frequency and accuracy of detection of individual serotypes. Ongoing monitoring with appropriate detection methods for OM pathogens can support development of improved vaccines to provide protection from the

  7. Topical administration of hyaluronic acid in children with recurrent or chronic middle ear inflammations.

    PubMed

    Torretta, Sara; Marchisio, Paola; Rinaldi, Vittorio; Gaffuri, Michele; Pascariello, Carla; Drago, Lorenzo; Baggi, Elena; Pignataro, Lorenzo

    2016-09-01

    Hyaluronic acid (HA) treatment has been successfully performed in patients with recurrent upper airway infections or rhinitis. The aim of this study was to assess the efficacy and safety of the topical nasal administration of an HA-based compound by investigating its effects in children with recurrent or chronic middle ear inflammations and chronic adenoiditis. A prospective, single-blind, 1:1 randomised controlled study was performed to compare otoscopy, tympanometry and pure-tone audiometry in children which received the daily topical administration of normal 0.9% sodium chloride saline solution (control group) or 9 mg of sodium hyaluronate in 3 mL of a 0.9% sodium saline solution. The final analysis was based on 116 children (49.1% boys; mean age, 62.9 ± 17.9 months): 58 in the control group and 58 in the study group. At the end of follow-up, the prevalence of patients with impaired otoscopy was significantly lower in the study group (P value = 0.024) compared to baseline but not in the control group. In comparison with baseline, the prevalence of patients with impaired tympanometry at the end of the follow-up period was significantly lower in the study group (P value = 0.047) but not in the control group. The reduction in the prevalence of patients with conductive hearing loss (CHL) (P value = 0.008) and those with moderate CHL (P value = 0.048) was significant in the study group, but not in the control group. The mean auditory threshold had also significantly improved by the end of treatment in the study group (P value = 0.004) but not in the control group. Our findings confirm the safety of intermittent treatment with a topical nasal sodium hyaluronate solution and are the first to document its beneficial effect on clinical and audiological outcomes in children with recurrent or chronic middle ear inflammations associated with chronic adenoiditis. PMID:27481884

  8. Comparative anatomy of the middle ear ossicles of extant hominids--Introducing a geometric morphometric protocol.

    PubMed

    Stoessel, Alexander; Gunz, Philipp; David, Romain; Spoor, Fred

    2016-02-01

    The presence of three interconnected auditory ossicles in the middle ear is a defining characteristic of mammals, and aspects of ossicle morphology are related to hearing sensitivity. However, analysis and comparison of ossicles are complicated by their minute size and complex three-dimensional shapes. Here we introduce a geometric morphometric measurement protocol for 3D shape analysis based on landmarks and semilandmarks obtained from μCT images and apply it to ossicles of extant hominids (great apes and humans). We show that the protocol is reliable and reproducible over a range of voxel resolutions, and captures even subtle shape differences. Using this approach it is possible to distinguish the hominid taxa by mean shapes of their malleus and incus (p < 0.01). The stapes appears less diagnostic, although this may in part be related to the small sample size available. Using ancestral state estimation, we show that, within hominids, Homo sapiens is derived with respect to its malleus (short manubrium, long corpus, head anterior-posterior flattened, articular facet shape), incus (wide intercrural curvature, long incudal processes, articular facet shape) and stapes (high stapes with kidney-shaped footplate). H. sapiens also shows a number of plesiomorphic shape traits whereas Gorilla and Pan possess a number of autapomorphic characteristics. The Pongo ossicles appear to be close to the plesiomorphic hominid condition. The malleus shows little difference in size among hominids, and allometry is thus of little importance. In contrast, the incus and stapes are more variable in size, and their shape is more strongly related to size differences. Although the form-function relationships in the middle ear are not fully understood, some aspects of ossicle morphology suggest that interspecific differences in hearing capacities are present among hominids. Finally, the results of this study provide a comparative framework for morphometric studies analyzing ossicles of

  9. Extratympanic observation of middle ear structure using a refractive index matching material (glycerol) and an infrared camera

    NASA Astrophysics Data System (ADS)

    Kong, Soo-Keun; Chon, Kyong-Myong; Goh, Eui-Kyung; Lee, Il-Woo; Wang, Soo-Geun

    2014-05-01

    High-resolution computed tomography has been used mainly in the diagnosis of middle ear disease, such as high-jugular bulb, congenital cholesteatoma, and ossicular disruption. However, certain diagnoses are confirmed through exploratory tympanotomy. There are few noninvasive methods available to observe the middle ear. The purpose of this study was to investigate the effect of glycerol as a refractive index matching material and an infrared (IR) camera system for extratympanic observation. 30% glycerol was used as a refractive index matching material in five fresh cadavers. Each material was divided into four subgroups; GN (glycerol no) group, GO (glycerol out) group, GI (glycerol in) group, and GB (glycerol both) group. A printed letter and middle ear structures on the inside tympanic membrane were observed using a visible and IR ray camera system. In the GB group, there were marked a transilluminated letter or an ossicle on the inside tympanic membrane. In particular, a footplate of stapes was even transilluminated using the IR camera system in the GB group. This method can be useful in the diagnosis of diseases of the middle ear if it is clinically applied through further studies.

  10. Extratympanic observation of middle ear structure using a refractive index matching material (glycerol) and an infrared camera.

    PubMed

    Kong, Soo-Keun; Chon, Kyong-Myong; Goh, Eui-Kyung; Lee, Il-Woo; Wang, Soo-Geun

    2014-05-01

    High-resolution computed tomography has been used mainly in the diagnosis of middle ear disease, such as high-jugular bulb, congenital cholesteatoma, and ossicular disruption. However, certain diagnoses are confirmed through exploratory tympanotomy. There are few noninvasive methods available to observe the middle ear. The purpose of this study was to investigate the effect of glycerol as a refractive index matching material and an infrared (IR) camera system for extratympanic observation. 30% glycerol was used as a refractive index matching material in five fresh cadavers. Each material was divided into four subgroups; GN (glycerol no) group, GO (glycerol out) group, GI (glycerol in) group, and GB (glycerol both) group. A printed letter and middle ear structures on the inside tympanic membrane were observed using a visible and IR ray camera system. In the GB group, there were marked a transilluminated letter or an ossicle on the inside tympanic membrane. In particular, a footplate of stapes was even transilluminated using the IR camera system in the GB group. This method can be useful in the diagnosis of diseases of the middle ear if it is clinically applied through further studies.

  11. Ontogeny of relationship of middle ear and temporomandibular (squamomandibular) joint in mammals. II. Morphology and ontogeny in insectivores.

    PubMed

    Smeele, L E

    1989-01-01

    The ontogeny of the mandibular joint and the middle ear region was studied in Erinaceus europaeus, Sorex araneus, Talpa europaea and Elephantulus rozeti. During development, a passage connection was found between the mandibular condyle and Meckel's cartilage that is produced by the primordium of the lateral pterygoid muscle. The articular disk is formed apart and it appears later in development.

  12. Ear tube insertion

    MedlinePlus

    Myringotomy; Tympanostomy; Ear tube surgery; Pressure equalization tubes; Ventilating tubes; Ear infection - tubes; Otitis - tubes ... trapped fluid can flow out of the middle ear. This prevents hearing loss and reduces the risk ...

  13. Ear tube insertion - slideshow

    MedlinePlus

    ... this page: //medlineplus.gov/ency/presentations/100045.htm Ear tube insertion - series—Normal anatomy To use the ... 4 Overview The eardrum (tympanic membrane) separates the ear canal from the middle ear. Update Date 8/ ...

  14. Active Coupled Oscillators in the Inner Ear

    NASA Astrophysics Data System (ADS)

    Strimbu, Clark Elliott

    Auditory and vestibular systems are endowed with an active process that enables them to detect signals as small as a few Angstroms; they also exhibit frequency selectivity; show strong nonlinearities; and can exhibit as spontaneous activity. Much of this active process comes from the sensory hair cells at the periphery of the auditory and vestibular systems. Each hair cell is capped by an eponymous hair bundle, a specialized structure that transduces mechanical forces into electrical signals. Experiments on mechanically decoupled cells from the frog sacculus have shown that individual hair bundles behave in an active manner analogous to an intact organ suggesting a common cellular basis for the active processes seen in many species. In particular, mechanically decoupled hair bundles show rapid active movements in response to transient stimuli and exhibit spontaneous oscillations. However, a single mechanosensitive hair cell is unable to match the performance of an entire organ. In vivo, hair bundles are often coupled to overlying membranes, gelatinous extracellular matrices. We used an in vitro preparation of the frog sacculus in which the otolithic membrane has been left intact. Under natural coupling conditions, there is a strong degree of correlation across the saccular epithelium, suggesting that the collective response of many cells contributes to the extreme sensitivity of this organ. When the membrane is left intact, the hair bundles do not oscillate spontaneously, showing that the natural coupling and loading tunes them into a quiescent regime. However, when stimulated by a pulse, the bundles show a rapid biphasic response that is abolished when the transduction channels are blocked. The active forces generated by the bundles are sufficient to move the overlying membrane.

  15. Kinetics of gentamicin uptake in the inner ear of Chinchilla langier after middle-ear administration in a sustained-release vehicle.

    PubMed

    Balough, B J; Hoffer, M E; Wester, D; O'Leary, M J; Brooker, C R; Goto, M

    1998-11-01

    The search for a safe, effective treatment for the vertigo associated with Meniere's disease has long been an important topic in otolaryngology. In recent years many groups have begun using intratympanic gentamicin to treat this vertigo. Although reported cure rates are as high as 90%, many questions remain regarding this type of treatment. Current limitations are the necessity for repeated treatments and a lack of clear dosing guidelines. In addition, the gentamicin must be delivered in a manner that allows maximal vestibulotoxic effect without injury to hearing. Until investigators can control the exact amount of medicine that is placed in the ear and have an understanding of the kinetics of gentamicin absorption, adequate dosing guidelines will be difficult to establish, and therapy will continue to rely on empiric data. We describe the use of a fibrin-based sustained-release vehicle, impregnated with gentamicin, injected into the middle ear of chinchillas. This allows for a prolonged effect without repeated dosing. Using this model, we studied the absorption kinetics of gentamicin at time points ranging from 8 hours to 1 week after injection. We used our findings to create a kinetics curve of gentamicin absorption. We discuss the shape and characteristics of this kinetics curve and examine the effects of the fibrin-based sustained-release vehicle and gentamicin on the middle ear. We noted no absorption in the contralateral (untreated ear) or blood. Through better understanding of the actions of gentamicin in this animal model, we hope to facilitate safer use of intratympanic medicines in our patient population and initiate programs for the use of this sustained-release vehicle in human beings. PMID:9807064

  16. Distortion product otoacoustic emissions for hearing threshold estimation and differentiation between middle-ear and cochlear disorders in neonates

    NASA Astrophysics Data System (ADS)

    Janssen, Thomas; Gehr, Daniel D.; Klein, Annette; Müller, Jörg

    2005-05-01

    Our aim in the present study was to apply extrapolated DPOAE I/O-functions [J. Acoust. Soc. Am. 111, 1810-1818 (2002); 113, 3275-3284 (2003)] in neonates in order to investigate their ability to estimate hearing thresholds and to differentiate between middle-ear and cochlear disorders. DPOAEs were measured in neonates after birth (mean age=3.2 days) and 4 weeks later (follow-up) at 11 test frequencies between f2=1.5 and 8 kHz and compared to that found in normal hearing subjects and cochlear hearing loss patients. On average, in a single ear hearing threshold estimation was possible at about 2/3 of the test frequencies. A sufficient test performance of the approach is therefore suggested. Thresholds were higher at the first measurement compared to that found at the follow-up measurement. Since thresholds varied with frequency, transitory middle ear dysfunction due to amniotic fluid instead of cochlear immaturity is suggested to be the cause for the change in thresholds. DPOAE behavior in the neonate ears differed from that found in the cochlear hearing loss ears. From a simple model it was concluded that the difference between the estimated DPOAE threshold and the DPOAE detection threshold is able to differentiate between sound conductive and cochlear hearing loss. .

  17. [Middle ear salivary gland choristoma related to branchio-oto-renal syndrome diagnosed by array-CGH].

    PubMed

    Amrhein, P; Sittel, C; Spaich, C; Kohlhase, J; Boppert, R; Kohlhof, P; Koitschev, A

    2014-05-01

    Branchio-oto-renal (BOR) syndrome is characterized by ear malformations associated with sensorineural or mixed hearing loss. In addition, preauricular tags, preauricular pits, branchial cleft fistulas and cysts, as well as renal dysplasia are seen. A genetic mutation on chromosome 8, either autosomal dominantly inherited or occuring as a spontaneous mutation, is the cause in the majority of cases. Using array-based comparative genomic hybridization (CGH), it is possible to detect even the smallest genetic changes. Salivary gland choristoma in the middle ear is very rare. Surgical removal and histological clarification are required.

  18. Semi-implantable middle ear electromagnetic hearing device for sensorineural hearing loss.

    PubMed

    Maniglia, A J; Ko, W H; Garverick, S L; Abbass, H; Kane, M; Rosenbaum, M; Murray, G

    1997-05-01

    A semi-implantable middle ear electromagnetic hearing device (SIMEHD) is proposed for limited clinical trial in adult patients to evaluate the implantable hearing device for moderate to severe sensorineural hearing loss. Food and Drug Administration (FDA) investigational device exemption (IDE) approval has been granted (May 1996) for clinical trials. The implant unit has been evaluated acutely and chronically in animals (cats) with excellent results. Five cats undergoing chronic implantation were allowed to survive an average of 9.6 months, showing that the SIMEHD is biocompatible, functional and without untoward complications. All implant units recovered from the cats were functional, except for wire breakage of the internal antenna. A new antenna was redesigned for human implantation. The SIMEHD system consists of an external and internal unit. The external unit consists of a microphone, audio amplifier, modulator, radio frequency (RF) amplifier, antenna and battery. The internal unit is composed of a receiving antenna, hybrid electronic circuit, air core driving coil, and a target magnet cemented to the incus. All materials in contact with the body are biocompatible and expected to survive indefinitely. The implant unit is miniaturized and manufactured with existing fabrication technology by our industrial collaborator, Wilson Greatbatch, Ltd. The specific aims and major tasks of the proposed research are: a) to evaluate reliability, safety and efficacy of the SIMEHD system in a selected group of patients diagnosed with sensorineural hearing loss, due mainly to presbycusis or aging of the inner ear; and b) to obtain objective and subjective evaluation of audiologic and psychoacoustic performance as compared to the acoustic hearing aid. This paper describes the design, illustrates the actual device (newest prototype) and details the technique for surgical implantation in the attic and mastoid antrum in humans.

  19. Finite-Element Modelling of the Response of the Gerbil Middle Ear to Sound.

    PubMed

    Maftoon, Nima; Funnell, W Robert J; Daniel, Sam J; Decraemer, Willem F

    2015-10-01

    We present a finite-element model of the gerbil middle ear that, using a set of baseline parameters based primarily on a priori estimates from the literature, generates responses that are comparable with responses we measured in vivo using multi-point vibrometry and with those measured by other groups. We investigated the similarity of numerous features (umbo, pars-flaccida and pars-tensa displacement magnitudes, the resonance frequency and break-up frequency, etc.) in the experimental responses with corresponding ones in the model responses, as opposed to simply computing frequency-by-frequency differences between experimental and model responses. The umbo response of the model is within the range of variability seen in the experimental data in terms of the low-frequency (i.e., well below the middle-ear resonance) magnitude and phase, the main resonance frequency and magnitude, and the roll-off slope and irregularities in the response above the resonance frequency, but is somewhat high for frequencies above the resonance frequency. At low frequencies, the ossicular axis of rotation of the model appears to correspond to the anatomical axis but the behaviour is more complex at high frequencies (i.e., above the pars-tensa break-up). The behaviour of the pars tensa in the model is similar to what is observed experimentally in terms of magnitudes, phases, the break-up frequency of the spatial vibration pattern, and the bandwidths of the high-frequency response features. A sensitivity analysis showed that the parameters that have the strongest effects on the model results are the Young's modulus, thickness and density of the pars tensa; the Young's modulus of the stapedial annular ligament; and the Young's modulus and density of the malleus. Displacements of the tympanic membrane and manubrium and the low-frequency displacement of the stapes did not show large changes when the material properties of the incus, stapes, incudomallear joint, incudostapedial joint, and

  20. The ear in subterranean insectivora and rodentia in comparison with ground-dwelling representatives. I. Sound conducting system of the middle ear.

    PubMed

    Burda, H; Bruns, V; Hickman, G C

    1992-10-01

    Compared to acoustically unspecialized mammals (soricids and murids), the middle ear of subterranean insectivores and rodents (twelve species of six families examined) was clearly distinguished and characterized by many common features: rather round and relatively larger eardrum without a pars flaccida; reduced gonial; loose or no connection between the malleus and the tympanic bone; reduced and straightened transversal part of the malleus; enlarged incus; increased and rather flat incudo-mallear joint; rather parallel position of the mallear manubrium and incudal crus longum in some species (and their fusion in bathyergids); reduced or even missing middle ear muscles. Convergent occurrence of these structural features in taxa of different origin and their generally derived character suggest that they cannot be categorized as degenerative. The form of the stapes can be considered as a non-adaptive trait; it was taxon specific yet remarkably polymorphous in some species and exhibited no convergent features among subterranean mammals. Structural retrogression resulting in a columella-like stapes was observed in some species lacking the stapedial artery. The stapedial base was relatively larger than in unspecialized mammals. The subterranean mammals did not exhibit conspicuously enlarged eardrums as would be required for sensitive tuning to low frequencies. It is, however, argued that while selective pressures in the subterranean ecotope promoted hearing of low frequencies, hearing sensitivity did not have to be enhanced.

  1. A study of sound transmission in an abstract middle ear using physical and finite element models.

    PubMed

    Gonzalez-Herrera, Antonio; Olson, Elizabeth S

    2015-11-01

    The classical picture of middle ear (ME) transmission has the tympanic membrane (TM) as a piston and the ME cavity as a vacuum. In reality, the TM moves in a complex multiphasic pattern and substantial pressure is radiated into the ME cavity by the motion of the TM. This study explores ME transmission with a simple model, using a tube terminated with a plastic membrane. Membrane motion was measured with a laser interferometer and pressure on both sides of the membrane with micro-sensors that could be positioned close to the membrane without disturbance. A finite element model of the system explored the experimental results. Both experimental and theoretical results show resonances that are in some cases primarily acoustical or mechanical and sometimes produced by coupled acousto-mechanics. The largest membrane motions were a result of the membrane's mechanical resonances. At these resonant frequencies, sound transmission through the system was larger with the membrane in place than it was when the membrane was absent.

  2. External unit for a semi-implantable middle ear hearing device.

    PubMed

    Garverick, S L; Kane, M; Ko, W H; Maniglia, A J

    1997-06-01

    A miniaturized, low-power external unit has been developed for the clinical trials of a semi-implantable middle ear electromagnetic hearing device (SIMEHD) which uses radio-frequency telemetry to couple sound signals to the internal unit. The external unit is based on a commercial hearing aid which provides proven audio amplification and compression. Its receiver is replaced by an application-specific integrated circuit (ASIC) which: 1) adjusts the direct-current bias of the audio input according to its peak value; 2) converts the audio signal to a one-bit digital form using sigma-delta modulation; 3) modulates the sigma-delta output with a radio-frequency (RF) oscillator; and 4) drives the external RF coil and tuning capacitor using a field-effect transistor operated in class D. The external unit functions as expected and has been used to operate bench-top tests to the SIMEHD. Measured current consumption is 1.65-2.15 mA, which projects to a battery lifetime of about 15 days. Bandwidth is 6 kHz and harmonic distortion is about 2%. PMID:9210807

  3. [Novel possibilities for the rehabilitation of patients presenting with congenital external and middle ear malformations].

    PubMed

    Mileshina, N A; Osipenkov, S S; Bakhshinian, V V; Tavartkiladze, G A

    2014-01-01

    The objective of the present study was to estimate the advantages of cochlear Baha BIA 400 abutments in the intraoperative and early postoperative periods. A total of 10 implantations of the systems with the use of hydroxyapatite bone cement were performed in 9 patients of different age. Stability of the implants and intensity of skin reactions were evaluated. The data obtained indicate that the use of cochlear Baha BIA 400 abutments significantly simplifies and shortens the surgical stage of rehabilitation producing a good cosmetic result. The use of the Osstell instrument made it possible to estimate stability of the implants intraoperatively and evaluate the effectiveness of osteointegration during the follow-up period. Analysis of the results of the study provided a basis on which to improve the quality and shorten duration of the rehabilitative treatment of the patients presenting with congenital external and middle ear malformations. Moreover, the data obtained can be used to develop practical recommendations for the further work in this area.

  4. Expression of female sex hormone receptors in human middle-ear cholesteatomas.

    PubMed

    Raynov, Alexander Markov; Choung, Yun-Hoon; Moon, Sung-Kyun; Park, Keehyun

    2005-12-01

    The purpose of this study was to establish the eventual presence of progesterone receptor (PGR) and oestrogen receptor (EGR) in human middle-ear cholesteatoma (MECh) tissues and to compare their expression between male and female patients. An immunohistochemical technique was employed for detection of PGR- and EGR-specific immunoreactivity in MECh samples using formalin-fixed paraffin-embedded tissue sections. The positive results were verified with reverse transcriptase polymerase chain reaction (RT-PCR). The morphological study revealed stable expression of PGR in suprabasal layers of all cholesteatoma samples. Weaker immunoreactivity for PGR was demonstrated in external auditory canal skin (EACS) samples in comparison with MECh, while PGR-specific staining was not observed in retroauricular skin (RAS) samples. EGR was detected only at mRNA levels. Stronger expression of EGR PCR products was disclosed in female cholesteatoma samples, while PGR mRNA was predominantly detected in male cholesteatoma specimens. Our preliminary experimental results give us ground to assume that female sex hormones may stimulate proliferation and affect differentiation of MECh keratinocytes.

  5. Ultrasound characterization of the mastoid for detecting middle ear effusion: A preliminary clinical validation

    PubMed Central

    Chen, Chin-Kuo; Fang, Jui; Wan, Yung-Liang; Tsui, Po-Hsiang

    2016-01-01

    Ultrasound detection of middle ear effusion (MEE) is an emerging technique in otolaryngology. This study proposed using ultrasound characterization of the mastoid to noninvasively measure MEE-induced mastoid effusion (ME) as a new strategy for determining the presence of MEE. In total, 53 patients were enrolled (Group I: normal, n = 20; Group II: proven MEE through both otoscopy and tympanometry, n = 15; Group III: patients with MEE having effusions observed during grommet surgery, n = 18). A 2.25-MHz delay-line transducer was used to measure backscattered signals from the mastoid. The Nakagami parameter was estimated using the acquired signals to model the echo amplitude distribution for quantifying changes in the acoustic structures of mastoid air cells. The median Nakagami parameter and interquartile range were 0.35 (0.34–0.37) for Group I, 0.39 (0.37–0.41) for Group II, and 0.43 (0.39–0.51) for Group III. The echo amplitude distribution observed for patients with MEE was closer to Rayleigh distribution than that without MEE. Receiver operating characteristic (ROC) curve analysis further revealed that the area under the ROC was 0.88, sensitivity was 72.73%, specificity was 95%, and accuracy was 81.13%. The proposed method has considerable potential for noninvasive and comfortable evaluation of MEE. PMID:27277543

  6. [Paraganglioma of the middle ear. The retrospective analysis of the results of the surgical treatment].

    PubMed

    Rzaev, R M; Rzaev, Rt R

    2016-01-01

    The objective of the present study was to analyze the results of and to summarize the experience with diagnostics and surgical treatment of the patients presenting with paraganglioma of the middle ear (PME). A total of 5 patients were available for the examination (all of the women) including two in whom the extension of the tumour corresponded to class A paraganglioma (according to the classification of U. Fisch) and three with class B paraganglioma (two having the tumour that occupied mezo- and hypotympanum and one with the tumour extending into the infralabyrinthine space). All the patients of the former group and 2 of the three in the latter group were operated with the use of the retroauricular-endomeatal approach. The remaining patient with class B paraganglioma extending into the infralabyrinthine space and the suspected destruction of the outer wall of the internal carotid artery by the tumour or its penetration into the channel was treated with the use of the retroauricular-endomeata-transmastoidal approach. The long-term postoperative catamnesticobservation of the thus treated patients has demonstrated the absence of a recurrent tumour within at least 3 tears after surgery. All the patientseported he preserved hearing function. PMID:27213651

  7. Femtosecond laser microstructuring of titanium surfaces for middle ear ossicular replacement prosthesis

    NASA Astrophysics Data System (ADS)

    Ilgner, Justus; Biedron, Slavomir; Fadeeva, Elena; Chichkov, Boris; Westhofen, Martin

    2009-02-01

    Introduction: While a variety of materials has been evaluated for replacement of human middle ear ossicles following inflammation, titanium and its alloys have shown excellent sound transmission properties and biocompatibility. However, cartilage thickness at the tympanic membrane interface deteriorates over time, while fibrous tissue formation may dislodge the titanium prosthesis. This study was performed to evaluate the effect of microstructures on titanium surfaces in contact with adjacent biological tissue. Materials and Methods: Titanium samples of 5mm diameter and 0,25mm thickness were structured by means of a Ti:Sapphire femtosecond laser operating at 970nm. The structures applied were lines of parabolic shape (cross-sectional) of 5µm (parallel), 5µm (cross-hatch) and 10µm width (parallel). The inter-groove distance between two maxima was exactly twice the line width. Results: Lines smaller than 5µm were not feasible due to the natural irregularity of the basic material with pits and level changes of up to 2µm. The process showed little debris and constant microstructure shape over the whole structured area (2x2mm). The resulting debris was examined for toxic by-products on human fibrobcytes and chondrocytes. Discussion: The results show that microstructures can be applied on titanium surfaces for human implantation with reproducible and constant shapes. Further studies will focus on cell culture which has suggested a relative selectivity for chondrocyte compared to fibrocyte growth in earlier studies with selected microstructures.

  8. Original Solution for Middle Ear Implant and Anesthetic/Surgical Management in a Child with Severe Craniofacial Dysmorphism.

    PubMed

    Bianchin, Giovanni; Tribi, Lorenzo; Reverzani, Aronne; Formigoni, Patrizia; Polizzi, Valeria

    2015-01-01

    We describe the novel solution adopted in positioning middle ear implant in a child with bilateral congenital aural atresia and craniofacial dysmorphism that have posed a significant challenge for the safe and correct management of deafness. A five-year-old child, affected by a rare congenital disease (Van Maldergem Syndrome), suffered from conductive hearing loss. Conventional skin-drive bone-conduction device, attached with a steel spring headband, has been applied but auditory restoration was not optimal. The decision made was to position Vibrant Soundbridge, a middle ear implant, with an original surgical application due to hypoplasia of the tympanic cavity. Intubation procedure was complicated due to child craniofacial deformities. Postoperative hearing rehabilitation involved a multidisciplinary team, showing improved social skills and language development. PMID:26491591

  9. A mistaken identity: rhabdomyosarcoma of the middle ear cleft misdiagnosed as chronic suppurative otitis media with temporal lobe abscess

    PubMed Central

    Muranjan, Mamta; Karande, Sunil; Parikh, Shefali; Sankhe, Shilpa

    2014-01-01

    A 5-year-old girl presented with a 3-month history of left side facial palsy, followed sequentially by purulent ear discharge, complete external ophthalmoplaegia and blurred vision. On clinical examination she was febrile with left-sided conductive hearing loss. She was clinically diagnosed to have chronic suppurative otitis media of the unsafe type with petrous apicitis, middle cranial fossa abscess and cavernous sinus involvement. Preliminary CT scan findings were reported as a large left temporal lobe abscess and left otitis media with cholesteatoma. MRI of the brain obtained later corroborated the abnormalities detected on the CT scan. Ten days after admission, a mass was seen protruding from the external auditory canal. A biopsy of the mass was obtained and sent for histopathological examination. Meanwhile, review of the MRI suggested an aggressive neoplasm such as sarcoma/rhabdomyosarcoma. Histopathology clinched the final diagnosis of an anaplastic type of embryonal rhabdomyosarcoma of the middle ear cleft. PMID:25240007

  10. Original Solution for Middle Ear Implant and Anesthetic/Surgical Management in a Child with Severe Craniofacial Dysmorphism

    PubMed Central

    Bianchin, Giovanni; Tribi, Lorenzo; Reverzani, Aronne; Formigoni, Patrizia; Polizzi, Valeria

    2015-01-01

    We describe the novel solution adopted in positioning middle ear implant in a child with bilateral congenital aural atresia and craniofacial dysmorphism that have posed a significant challenge for the safe and correct management of deafness. A five-year-old child, affected by a rare congenital disease (Van Maldergem Syndrome), suffered from conductive hearing loss. Conventional skin-drive bone-conduction device, attached with a steel spring headband, has been applied but auditory restoration was not optimal. The decision made was to position Vibrant Soundbridge, a middle ear implant, with an original surgical application due to hypoplasia of the tympanic cavity. Intubation procedure was complicated due to child craniofacial deformities. Postoperative hearing rehabilitation involved a multidisciplinary team, showing improved social skills and language development. PMID:26491591

  11. Value of middle ear inflation as a diagnostic indicator of eustachian tube patency.

    PubMed

    Luntz, M; Sadé, J

    1990-02-01

    The value of tubal inflation as a diagnostic procedure for Eustachian tube patency and function is controversial. In an attempt to assess the diagnostic value of air douche in atelectatic ears, 49 such ears of 40 patients were politzerized. The procedure was successful in 45 ears. However, of the four unsuccessful cases, two of the patients were able to autoinflate their ears. These results show that air douches pass regularly through the Eustachian tube into the tympanic cavity even in atelectatic ears, which by definition suffer from aeration deficiency, which is often considered to be secondary to 'Eustachian tube obstruction', or alternatively 'Eustachian tube dysfunction'. Thus, the ability to force air through the Eustachian tube by politzerization is of no diagnostic value as an indicator of normal or abnormal tubal patency or functioning in atelectatic ears and most probably in allied conditions. PMID:2324620

  12. Esteem® middle ear device versus conventional hearing aids for rehabilitation of bilateral sensorineural hearing loss.

    PubMed

    Monini, Simonetta; Biagini, Michela; Atturo, Francesca; Barbara, Maurizio

    2013-07-01

    This retrospective study aimed to evaluate the efficacy of the Esteem(®) middle ear implant in sensorineural hearing loss (SNHL) of different degree as well as to compare it with that obtained with conventional hearing aids. Fifteen out of 30 adults patients who received an Esteem(®) middle ear device for rehabilitation of sensorineural hearing loss met the primary eligibility criterion of prior, continuous use of conventional hearing aids. Study population included moderate-to-severe SNHL (8 patients) and severe-to-profound SNHL (7 patients). Audiometric measurements included free-field pure-tone and speech audiometry in Esteem(®)-aided, HA-aided, and baseline threshold. For speech audiometry, speech reception threshold (SRT) and word recognition score (WRS) were assessed. Subjective benefit was evaluated by Client Oriented Scale of Improvement (COSI) questionnaire. In all the subjects, SRT and WRS showed improvement both with conventional HA and Esteem(®) in respect to the unaided situation. Although not statistically significant, a slight prevalence of the Esteem(®) performances was recorded both audiometrically and as subjective satisfaction score. The Esteem(®) middle ear device demonstrated appreciable benefit for rehabilitation of SNHL of different degree, comparable to what can be achieved by conventional hearing aids. In addition, this rehabilitative process may enable also individuals presenting with severe-to-profound SNHL to achieve remarkable functional outcomes.

  13. Mammalian development does not recapitulate suspected key transformations in the evolutionary detachment of the mammalian middle ear.

    PubMed

    Ramírez-Chaves, Héctor E; Wroe, Stephen W; Selwood, Lynne; Hinds, Lyn A; Leigh, Chris; Koyabu, Daisuke; Kardjilov, Nikolay; Weisbecker, Vera

    2016-01-13

    The ectotympanic, malleus and incus of the developing mammalian middle ear (ME) are initially attached to the dentary via Meckel's cartilage, betraying their origins from the primary jaw joint of land vertebrates. This recapitulation has prompted mostly unquantified suggestions that several suspected--but similarly unquantified--key evolutionary transformations leading to the mammalian ME are recapitulated in development, through negative allometry and posterior/medial displacement of ME bones relative to the jaw joint. Here we show, using µCT reconstructions, that neither allometric nor topological change is quantifiable in the pre-detachment ME development of six marsupials and two monotremes. Also, differential ME positioning in the two monotreme species is not recapitulated. This challenges the developmental prerequisites of widely cited evolutionary scenarios of definitive mammalian middle ear (DMME) evolution, highlighting the requirement for further fossil evidence to test these hypotheses. Possible association between rear molar eruption, full ME ossification and ME detachment in marsupials suggests functional divergence between dentary and ME as a trigger for developmental, and possibly also evolutionary, ME detachment. The stable positioning of the dentary and ME supports suggestions that a 'partial mammalian middle ear' as found in many mammaliaforms--probably with a cartilaginous Meckel's cartilage--represents the only developmentally plausible evolutionary DMME precursor.

  14. Mammalian development does not recapitulate suspected key transformations in the evolutionary detachment of the mammalian middle ear.

    PubMed

    Ramírez-Chaves, Héctor E; Wroe, Stephen W; Selwood, Lynne; Hinds, Lyn A; Leigh, Chris; Koyabu, Daisuke; Kardjilov, Nikolay; Weisbecker, Vera

    2016-01-13

    The ectotympanic, malleus and incus of the developing mammalian middle ear (ME) are initially attached to the dentary via Meckel's cartilage, betraying their origins from the primary jaw joint of land vertebrates. This recapitulation has prompted mostly unquantified suggestions that several suspected--but similarly unquantified--key evolutionary transformations leading to the mammalian ME are recapitulated in development, through negative allometry and posterior/medial displacement of ME bones relative to the jaw joint. Here we show, using µCT reconstructions, that neither allometric nor topological change is quantifiable in the pre-detachment ME development of six marsupials and two monotremes. Also, differential ME positioning in the two monotreme species is not recapitulated. This challenges the developmental prerequisites of widely cited evolutionary scenarios of definitive mammalian middle ear (DMME) evolution, highlighting the requirement for further fossil evidence to test these hypotheses. Possible association between rear molar eruption, full ME ossification and ME detachment in marsupials suggests functional divergence between dentary and ME as a trigger for developmental, and possibly also evolutionary, ME detachment. The stable positioning of the dentary and ME supports suggestions that a 'partial mammalian middle ear' as found in many mammaliaforms--probably with a cartilaginous Meckel's cartilage--represents the only developmentally plausible evolutionary DMME precursor. PMID:26763693

  15. Super Ears.

    ERIC Educational Resources Information Center

    Thompson, Stan

    1995-01-01

    Presents an activity in which students design, construct, and test "super ears" to investigate sound and hearing. Students work in groups of three and explore how the outer ear funnels sound waves to the inner ear and how human hearing compares to that of other animals. (NB)

  16. Influence of the middle ear anatomy on the performance of a membrane sensor in the incudostapedial joint gap.

    PubMed

    Koch, Martin; Seidler, Hannes; Hellmuth, Alexander; Bornitz, Matthias; Lasurashvili, Nikoloz; Zahnert, Thomas

    2013-07-01

    There is a great demand for implantable microphones for future generations of implantable hearing aids, especially Cochlea Implants. An implantable middle ear microphone based on a piezoelectric membrane sensor for insertion into the incudostapedial gap is investigated. The sensor is designed to measure the sound-induced forces acting on the center of the membrane. The sensor mechanically couples to the adjacent ossicles via two contact areas, the sensor membrane and the sensor housing. The sensing element is a piezoelectric single crystal bonded on a titanium membrane. The sensor allows a minimally invasive and reversible implantation without removal of ossicles and without additional sensor fixation in the tympanic cavity. This study investigates the implantable microphone sensor and its implantation concept. It intends to quantify the influence of the sensor's insertion position on the achievable microphone sensitivity. The investigation considers anatomical and pathological variations of the middle ear geometry and its space limitations. Temporal bone experiments on a laboratory model show that anatomical and pathological variations of the middle ear geometry can prevent the sensor from being placed optimally within the incudostapedial joint. Beyond scattering of transfer functions due to anatomic variations of individual middle ears there is the impact of variations in the sensor position within the ossicular chain that has a considerable effect on the transfer characteristics of the middle ear microphone. The centering of the sensor between incus and stapes, the direction of insertion (membrane to stapes or to incus) and the effect of additional contact points with surrounding anatomic structures affect the signal yield of the implanted sensor. The presence of additional contact points has a considerably impact on the sensitivity, yet the microphone sensitivity is quite robust against small changes in the positioning of the incus on the sensor. Signal losses

  17. Ontogeny of the Middle-Ear Air-Sinus System in Alligator mississippiensis (Archosauria: Crocodylia).

    PubMed

    Dufeau, David L; Witmer, Lawrence M

    2015-01-01

    volume, but instead support the hypothesis that these changes may be a function of the acoustic properties of the middle ear. PMID:26398659

  18. Ontogeny of the Middle-Ear Air-Sinus System in Alligator mississippiensis (Archosauria: Crocodylia)

    PubMed Central

    Dufeau, David L.; Witmer, Lawrence M.

    2015-01-01

    volume, but instead support the hypothesis that these changes may be a function of the acoustic properties of the middle ear. PMID:26398659

  19. 15 CFR 734.5 - Activities of U.S. and foreign persons subject to the EAR.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... subject to the EAR. 734.5 Section 734.5 Commerce and Foreign Trade Regulations Relating to Commerce and... subject to the EAR. The following kinds of activities are subject to the EAR: (a) Certain activities of U..., missile technology as described in § 744.6 of the EAR, and the proliferation of chemical weapons...

  20. 15 CFR 734.5 - Activities of U.S. and foreign persons subject to the EAR.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... subject to the EAR. 734.5 Section 734.5 Commerce and Foreign Trade Regulations Relating to Commerce and... subject to the EAR. The following kinds of activities are subject to the EAR: (a) Certain activities of U..., missile technology as described in § 744.6 of the EAR, and the proliferation of chemical weapons...

  1. 15 CFR 734.5 - Activities of U.S. and foreign persons subject to the EAR.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... subject to the EAR. 734.5 Section 734.5 Commerce and Foreign Trade Regulations Relating to Commerce and... subject to the EAR. The following kinds of activities are subject to the EAR: (a) Certain activities of U..., missile technology as described in § 744.6 of the EAR, and the proliferation of chemical weapons...

  2. 15 CFR 734.5 - Activities of U.S. and foreign persons subject to the EAR.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... subject to the EAR. 734.5 Section 734.5 Commerce and Foreign Trade Regulations Relating to Commerce and... subject to the EAR. The following kinds of activities are subject to the EAR: (a) Certain activities of U..., missile technology as described in § 744.6 of the EAR, and the proliferation of chemical weapons...

  3. 15 CFR 734.5 - Activities of U.S. and foreign persons subject to the EAR.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... subject to the EAR. 734.5 Section 734.5 Commerce and Foreign Trade Regulations Relating to Commerce and... subject to the EAR. The following kinds of activities are subject to the EAR: (a) Certain activities of U..., missile technology as described in § 744.6 of the EAR, and the proliferation of chemical weapons...

  4. In vivo areal modulus of elasticity estimation of the human tympanic membrane system: modelling of middle ear mechanical function in normal young and aged ears.

    PubMed

    Gaihede, Michael; Liao, Donghua; Gregersen, Hans

    2007-02-01

    The quasi-static elastic properties of the tympanic membrane system can be described by the areal modulus of elasticity determined by a middle ear model. The response of the tympanic membrane to quasi-static pressure changes is determined by its elastic properties. Several clinical problems are related to these, but studies are few and mostly not comparable. The elastic properties of membranes can be described by the areal modulus, and these may also be susceptible to age-related changes reflected by changes in the areal modulus. The areal modulus is determined by the relationship between membrane tension and change of the surface area relative to the undeformed surface area. A middle ear model determined the tension-strain relationship in vivo based on data from experimental pressure-volume deformations of the human tympanic membrane system. The areal modulus was determined in both a younger (n = 10) and an older (n = 10) group of normal subjects. The areal modulus for lateral and medial displacement of the tympanic membrane system was smaller in the older group (mean = 0.686 and 0.828 kN m(-1), respectively) compared to the younger group (mean = 1.066 and 1.206 kN m(-1), respectively), though not significantly (2p = 0.10 and 0.11, respectively). Based on the model the areal modulus was established describing the summated elastic properties of the tympanic membrane system. Future model improvements include exact determination of the tympanic membrane area accounting for its shape via 3D finite element analyses. In vivo estimates of Young's modulus in this study were a factor 2-3 smaller than previously found in vitro. No significant age-related differences were found in the elastic properties as expressed by the areal modulus.

  5. Ear problems in swimmers.

    PubMed

    Wang, Mao-Che; Liu, Chia-Yu; Shiao, An-Suey; Wang, Tyrone

    2005-08-01

    Acute diffuse otitis externa (swimmer's ear), otomycosis, exostoses, traumatic eardrum perforation, middle ear infection, and barotraumas of the inner ear are common problems in swimmers and people engaged in aqua activities. The most common ear problem in swimmers is acute diffuse otitis externa, with Pseudomonas aeruginosa being the most common pathogen. The symptoms are itching, otalgia, otorrhea, and conductive hearing loss. The treatment includes frequent cleansing of the ear canal, pain control, oral or topical medications, acidification of the ear canal, and control of predisposing factors. Swimming in polluted waters and ear-canal cleaning with cotton-tip applicators should be avoided. Exostoses are usually seen in people who swim in cold water and present with symptoms of accumulated debris, otorrhea and conductive hearing loss. The treatment for exostoses is transmeatal surgical removal of the tumors. Traumatic eardrum perforations may occur during water skiing or scuba diving and present with symptoms of hearing loss, otalgia, otorrhea, tinnitus and vertigo. Tympanoplasty might be needed if the perforations do not heal spontaneously. Patients with chronic otitis media with active drainage should avoid swimming, while patients who have undergone mastoidectomy and who have no cavity problems may swim. For children with ventilation tubes, surface swimming is safe in a clean, chlorinated swimming pool. Sudden sensorineural hearing loss and some degree of vertigo may occur after diving because of rupture of the round or oval window membrane.

  6. Implementation of a direct install 3-pole type EM transducer in round window niche for implantable middle ear hearing aids.

    PubMed

    Shin, Dong Ho; Lim, Hyung-Gyu; Jung, Eui Sung; Wei, Qun; Seong, Ki Woong; Lee, Jyung Hyun; Lee, Seung-Ha; Cho, Jin Ho

    2014-01-01

    Since the 1980's, various types of implantable hearing aids using unique means for delivering acoustic power to the inner ear have been developed. Recently, implantable hearing aids that stimulate the round window by the middle ear transducer have received great attention because it reduces loading effect at the ossicular chain. In this study, we have implemented a direct install 3-pole type EM transducer in round window niche for implantable middle ear hearing aid. The 3-pole type EM transducer consists of two permanent magnets and three coils and exhibit structural features that minimize leakage flux, thereby permitting high efficiency and low magnetic field interference. The stapes velocity was measured using a laser Doppler vibrometer in response to the round window stimulation from the transducer. To verify the usefulness of the 3-pole type EM transducer, we compared the stapes vibration characteristics produced by the transducer and those from a sound source. The magnitude of stapes velocity due to the round window stimulation at 1 mArms was equivalent to that of stapes velocity at 94 dB SPL sound stimulation. Thus, the evaluation study shows that the 3-pole type EM transducer is suitable for implantable hearing devices.

  7. Mice Haploinsufficient for Ets1 and Fli1 Display Middle Ear Abnormalities and Model Aspects of Jacobsen Syndrome.

    PubMed

    Carpinelli, Marina R; Kruse, Elizabeth A; Arhatari, Benedicta D; Debrincat, Marlyse A; Ogier, Jacqueline M; Bories, Jean-Christophe; Kile, Benjamin T; Burt, Rachel A

    2015-07-01

    E26 transformation-specific 1 (ETS1) and friend leukemia integration 1 (FLI1) are members of the ETS family of transcription factors, of which there are 28 in humans. Both genes are hemizygous in Jacobsen syndrome, an 11q contiguous gene deletion disorder involving thrombocytopenia, facial dysmorphism, growth and mental retardation, malformation of the heart and other organs, and hearing impairment associated with recurrent ear infections. To determine whether any of these defects are because of hemizygosity for ETS1 and FLI1, we characterized the phenotype of mice heterozygous for mutant alleles of Ets1 and Fli1. Fli1(+/-) mice displayed mild thrombocytopenia, as did Ets1(+/-)Fli1(+/-) animals. Fli1(+/-) and Ets1(+/-)Fli1(+/-) mice also displayed craniofacial abnormalities, including a small middle ear cavity, short nasal bone, and malformed interface between the nasal bone process and cartilaginous nasal septum. They exhibited hearing impairment, otitis media, fusions of ossicles to the middle ear wall, and deformed stapes. Hearing impairment was more penetrant and stapes malformations were more severe in Ets1(+/-)Fli1(+/-) mice than in Fli1(+/-) mice, indicating partial functional redundancy of these transcription factors during auditory development. Our findings indicate that the short nose, otitis media, and hearing impairment in Jacobsen syndrome are likely because of hemizygosity for ETS1 and FLI1.

  8. Implementation of a direct install 3-pole type EM transducer in round window niche for implantable middle ear hearing aids.

    PubMed

    Shin, Dong Ho; Lim, Hyung-Gyu; Jung, Eui Sung; Wei, Qun; Seong, Ki Woong; Lee, Jyung Hyun; Lee, Seung-Ha; Cho, Jin Ho

    2014-01-01

    Since the 1980's, various types of implantable hearing aids using unique means for delivering acoustic power to the inner ear have been developed. Recently, implantable hearing aids that stimulate the round window by the middle ear transducer have received great attention because it reduces loading effect at the ossicular chain. In this study, we have implemented a direct install 3-pole type EM transducer in round window niche for implantable middle ear hearing aid. The 3-pole type EM transducer consists of two permanent magnets and three coils and exhibit structural features that minimize leakage flux, thereby permitting high efficiency and low magnetic field interference. The stapes velocity was measured using a laser Doppler vibrometer in response to the round window stimulation from the transducer. To verify the usefulness of the 3-pole type EM transducer, we compared the stapes vibration characteristics produced by the transducer and those from a sound source. The magnitude of stapes velocity due to the round window stimulation at 1 mArms was equivalent to that of stapes velocity at 94 dB SPL sound stimulation. Thus, the evaluation study shows that the 3-pole type EM transducer is suitable for implantable hearing devices. PMID:25226951

  9. Low-Frequency Sound Pressure and Transtympanic Endoscopy of the Middle Ear in Assessment of “Spontaneous” Perilymphatic Fistula

    PubMed Central

    Pyykkö, Ilmari; Selmani, Ziane; Zou, Jing

    2012-01-01

    This study was designed to verify an eventual perilymphatic fistula (PLF) in 264 patients with sensorineural hearing loss (SNHL) and/or vertigo. The patients were exposed to a low-frequency sound stimulation (LFS) on posturography to objectively test Tullio's phenomenon and Hennebert's sign. Endoscopes with 5 degree and 25 degree of visual angle and an outer diameter of 1.7 mm were used. The round window niche, with its foldings, oval window with stapes superstructure, a part of the facial recess and the area in the fissula ante fenestram were examined and video recorded. In one patient, we endoscopically verified a fistula in the round window membrane (resulting from a diving accident) that was covered with a fibrinous layer. In 4 cases, there was abnormal mucosal shining in the round window but without PLF. In 7 cases, the tympanic cavity could not be visualized because of the adhesive middle ear process, the abnormal anatomy, or the prominent exostoses of the ear canal prohibited vision. In 34 patients, LFS provoked unsteadiness on posturography without PLF. In 6 cases, a postoperative middle ear infection was recorded. No permanent tympanic membrane perforation occurred. It is unlikely that disease entity of “spontaneous PLF” exists. Tympanoscopy should be regarded as the first choice when a PLF is suspected. PMID:23724265

  10. Inadvertent insertion of hearing aid impression material into the middle ear: Case report and implications for future community hearing services☆

    PubMed Central

    Algudkar, Ashwin; Maden, Belma; Singh, Arvind; Tatla, Taran

    2013-01-01

    INTRODUCTION The creation of ear moulds for hearing aids is generally considered a safe and routine procedure for trained professionals. In the literature there are reports of otological complications caused by hearing aid mould impression material in the middle ear cavity but such complications are considered rare. PRESENTATION OF CASE We present the case of a patient in whom impression material entered the middle ear through a perforation of the tympanic membrane during the process of making a hearing aid mould and review how this was managed. DISCUSSION We discuss how many aspects of the British Society of Audiology guidelines were not followed during this procedure and make recommendations as to how independent community practitioners need to be closely supervised with regular review to minimise the risks of such complications. CONCLUSION Our report demonstrates how a serious otological complication from the creation of a hearing aid impression in a community based private hearing clinic was managed. The reporting of such complications is rare but the incidence is likely to be much higher than the literature would suggest. We recommend and advise how these adverse incidents may be minimised and managed through competency reviews and formal referral links from community centres to hospital otolaryngology/audiology departments. PMID:24262374

  11. Otitis media with effusion: Accuracy of tympanometry in detecting fluid in the middle ears of children at myringotomies

    PubMed Central

    Anwar, Khurshid; Khan, Saeed; Rehman, Habib ur; Javaid, Mohammad; Shahabi, Isteraj

    2016-01-01

    Objective: (1) The diagnostic accuracy of tympanometry in detecting fluid in the middle ear space in children with otitis media with effusion by comparing its findings with those of myringotomies. (2) Identify the age group most commonly affected by OME. Methods: This prospective study was conducted at the Department of ENT& Head and Neck Surgery, Postgraduate Medical Institute Hayatabad Medical complex, Peshawar from July 1, 2012 to April 30, 2015. Patients with suspicion of OME underwent tympanometry and later myringotomies. Using Jerger’s classification, Type B tympanogram with normal canal volume was considered as conclusive evidence of fluid in the middle ear space. Its findings were compared with those of the respective myringotomies. From the data collected, the accuracy, sensitivity, specificity, positive predictive value and negative predictive values were calculated. Results: A total 117 ears of 63 patients were operated. The age range was 3 to 12 years. The commonest age group (58.7%) affected by OME was 6-8 years. Type B tympanogram with flat curve and normal canal volume was obtained in 71.4% of the ears. Comparison with myringotomy findings showed TP 85, TN 13, FP 5 and FN 14. The diagnostic value of tympanometry was; Sensitivity 85.85%, Specificity 72.22%, PPV 94.44%, NPV 48.14% and Accuracy of 83.76%. P value calculated using chi square test showed that there was significant difference between tympanometry and myringotomy findings in OME (p < 0.05). Conclusions: OME is common in age group 6-8 years. Tympanogram Type B with normal canal volume is fairly sensitive in diagnosing this condition. However for occurrence of false positive results, final decision regarding management should be made on clinical findings and other supportive audiological tests. PMID:27182263

  12. A new method to estimate sound energy entering the middle ear.

    PubMed

    Chen, Shixiong; Deng, Jun; Bian, Lin; Li, Guanglin

    2013-01-01

    Standing waves in the ear canal can cause inaccurate quantification of the sound pressure level (SPL) entering the ear and therefore lead to unreliable results in clinical tests. Since it is impractical to directly measure the SPL at the eardrum position, in this study we proposed a new method to estimate the eardrum SPL by solely making measurement at the entry of the ear canal. To achieve this, the acoustic characteristics of the earphone were calculated using a calculation tube with variable lengths. Then the ear canal impedance was calculated according to the obtained source characteristics. Finally, the eardrum SPL was estimated by the ear-canal impedance and the SPL measured at the entry of the ear canal. The results showed that the eardrum SPL could be reliably estimated for all the five subjects participated in this study. The maximal estimation error was less than 3 dB for all frequencies from 0.5 to 10 kHz. These findings suggested that the proposed method could avoid the standing wave problem and therefore might be a great candidate for accurate calibration of sound pressure in various acoustic measurements.

  13. Radiation-Induced Middle Ear and Mastoid Opacification in Skull Base Tumors Treated With Radiotherapy

    SciTech Connect

    Walker, Gary V.; Ahmed, Salmaan; Allen, Pamela; Gidley, Paul W.; Woo, Shiao Y.; DeMonte, Franco; Chang, Eric L.; Mahajan, Anita

    2011-12-01

    Purpose: To assess the incidence of middle ear (ME) pathology in patients treated with radiotherapy (RT) for skull base tumors. Methods and Materials: A retrospective analysis of 61 patients treated with RT between 2003 and 2008 for skull base tumors was conducted. Clinical outcomes and demographics were reviewed. Dose-volume histogram analysis was performed on the eustachian canal (EC), ME, mastoid air cells, vestibular apparatus, cochlea, internal auditory canal, lateral and posterior nasopharynx, and temporal lobes to relate doses to symptoms and radiographic change. Otomastoid opacification was rated 0 (none), 1 (mild), 2 (moderate), and 3 (severe) by a neuroradiologist blinded to clinical outcomes and doses. Results: The median prescribed dose was 50.4 Gy (range, 14-74 Gy). The ME mean dose was 14 Gy and 34 Gy for Grade 0-1 and 2-3 opacification, respectively (p < 0.0001). The mean mastoid dose was 10 Gy and 26 Gy for Grade 0-1 and 2-3, respectively (p < 0.0001). The mean EC dose was 17 Gy and 32 Gy for Grade 0-1 and 2-3, respectively (p = 0.0001). Otomastoid opacification resolved in 17 of 40 patients (42.5%), at a mean of 17 months after RT (range, 2-45 months). Otomastoid opacification persisted in 23 of 40 patients (57.5%), with a mean follow-up of 23 months (range, 2-55 months). Multivariate analysis showed that mastoid dose >30 Gy (odds ratio = 28.0, p < 0.001) and posterior nasopharynx dose of >30 Gy (odds ratio = 4.9, p = 0.009) were associated with Grade 2-3 effusions, whereas other factors including dose to EC and ME were not significant. Conclusions: A mean RT dose >30 Gy to the mastoid air cells or posterior nasopharynx is associated with increased risk of moderate to severe otomastoid opacification, which persisted in more than half of patients at 2-year follow-up.

  14. Presence of specific viruses in the middle ear fluids and respiratory secretions of young children with acute otitis media.

    PubMed

    Nokso-Koivisto, Johanna; Räty, Riitta; Blomqvist, Soile; Kleemola, Marjaana; Syrjänen, Ritva; Pitkäranta, Anne; Kilpi, Terhi; Hovi, Tapani

    2004-02-01

    The purpose of the study was to investigate the presence of different viruses in middle ear fluids and nasopharyngeal aspirates in young children with acute otitis media. Two cohorts of children (N = 329 and 611) were followed from 2 to 24 months of age in Finland in two prospective studies (Finnish Otitis Media Cohort Study and Finnish Otitis Media Vaccine Trial). During the study period, nasopharyngeal and middle ear fluid specimens for each acute otitis media event were examined for eight (Cohort Study) or ten (Vaccine Trial) common respiratory viruses; adenoviruses, influenza viruses A and B, parainfluenza viruses 1, 2, and 3, respiratory syncytial virus (RSV), enteroviruses, parechoviruses, and rhinoviruses. Picornaviruses (rhinoviruses, enteroviruses, and parechoviruses) were determined by reverse transcription PCR while antigen detection was used for the other viruses. A virus was present in either nasopharyngeal or middle ear specimen in 54% of events in the first cohort and in 67% of events in the second. Rhinoviruses formed the most common virus group detected (41-32%), followed by enteroviruses (25%, sought in the second cohort only) and respiratory syncytial virus (RSV) (10%). All the other viruses represented jointly 8-10% of the events. In conclusion, using the methods described in this study, a specific virus infection was diagnosed in two thirds of all acute otitis media events in young children. Picornavirus RNA was detected in association with more than a half of all acute otitis media events. The use of PCR-based methods for the other respiratory viruses might have increased further the overall virus detection rate in acute otitis media.

  15. Ear - blocked at high altitudes

    MedlinePlus

    ... ears; Flying and blocked ears; Eustachian tube dysfunction - high altitude ... the middle ear and the back of the nose and upper throat. ... down from high altitudes. Chewing gum the entire time you are ...

  16. Highly biocompatible behaviour and slow degradation of a LDH (layered double hydroxide)-coating on implants in the middle ear of rabbits.

    PubMed

    Duda, Franziska; Kieke, Marc; Waltz, Florian; Schweinefuß, Maria E; Badar, Muhammad; Müller, Peter Paul; Esser, Karl-Heinz; Lenarz, Thomas; Behrens, Peter; Prenzler, Nils Kristian

    2015-01-01

    Chronic inflammation can irreversibly damage components of the ossicular chain which may lead to sound conduction deafness. The replacement of impaired ossicles with prostheses does not reduce the risk of bacterial infections which may lead to loss of function of the implant and consequently to additional damage of the connected structures such as inner ear, meninges and brain. Therefore, implants that could do both, reconstruct the sound conduction and in addition provide antibacterial protection are of high interest for ear surgery. Layered double hydroxides (LDHs) are promising novel biomaterials that have previously been used as an antibiotic-releasing implant coating to curb bacterial infections in the middle ear. However, animal studies of LDHs are scarce and there exist only few additional data on the biocompatibility and hardly any on the biodegradation of these compounds. In this study, middle ear prostheses were coated with an LDH compound, using suspensions of nanoparticles of an LDH containing Mg and Al as well as carbonate ions. These coatings were characterized and implanted into the middle ear of healthy rabbits for 10 days. Analysis of the explanted prostheses showed only little signs of degradation. A stable health constitution was observed throughout the whole experiment in every animal. The results show that LDH-based implant coatings are biocompatible and dissolve only slowly in the middle ear. They, therefore, appear as promising materials for the construction of controlled drug delivery vehicles.

  17. Ear Infections in Children

    MedlinePlus

    ... shaped organ that converts sound vibrations from the middle ear into electrical signals. The auditory nerve carries these signals from the cochlea to the brain. Other nearby parts of the ear also can be involved in ...

  18. Ear infection - chronic

    MedlinePlus

    Middle ear infection - chronic; Otitis media - chronic; Chronic otitis media; Chronic ear infection ... Chole RA. Chronic otitis media, mastoiditis, and petrositis. In: Flint PW, Haughey BH, Lund V, et al, eds. Cummings Otolaryngology: Head & Neck Surgery . 6th ed. ...

  19. The physics of hearing: fluid mechanics and the active process of the inner ear

    NASA Astrophysics Data System (ADS)

    Reichenbach, Tobias; Hudspeth, A. J.

    2014-07-01

    Most sounds of interest consist of complex, time-dependent admixtures of tones of diverse frequencies and variable amplitudes. To detect and process these signals, the ear employs a highly nonlinear, adaptive, real-time spectral analyzer: the cochlea. Sound excites vibration of the eardrum and the three miniscule bones of the middle ear, the last of which acts as a piston to initiate oscillatory pressure changes within the liquid-filled chambers of the cochlea. The basilar membrane, an elastic band spiraling along the cochlea between two of these chambers, responds to these pressures by conducting a largely independent traveling wave for each frequency component of the input. Because the basilar membrane is graded in mass and stiffness along its length, however, each traveling wave grows in magnitude and decreases in wavelength until it peaks at a specific, frequency-dependent position: low frequencies propagate to the cochlear apex, whereas high frequencies culminate at the base. The oscillations of the basilar membrane deflect hair bundles, the mechanically sensitive organelles of the ear's sensory receptors, the hair cells. As mechanically sensitive ion channels open and close, each hair cell responds with an electrical signal that is chemically transmitted to an afferent nerve fiber and thence into the brain. In addition to transducing mechanical inputs, hair cells amplify them by two means. Channel gating endows a hair bundle with negative stiffness, an instability that interacts with the motor protein myosin-1c to produce a mechanical amplifier and oscillator. Acting through the piezoelectric membrane protein prestin, electrical responses also cause outer hair cells to elongate and shorten, thus pumping energy into the basilar membrane's movements. The two forms of motility constitute an active process that amplifies mechanical inputs, sharpens frequency discrimination, and confers a compressive nonlinearity on responsiveness. These features arise because the

  20. The physics of hearing: fluid mechanics and the active process of the inner ear.

    PubMed

    Reichenbach, Tobias; Hudspeth, A J

    2014-07-01

    Most sounds of interest consist of complex, time-dependent admixtures of tones of diverse frequencies and variable amplitudes. To detect and process these signals, the ear employs a highly nonlinear, adaptive, real-time spectral analyzer: the cochlea. Sound excites vibration of the eardrum and the three miniscule bones of the middle ear, the last of which acts as a piston to initiate oscillatory pressure changes within the liquid-filled chambers of the cochlea. The basilar membrane, an elastic band spiraling along the cochlea between two of these chambers, responds to these pressures by conducting a largely independent traveling wave for each frequency component of the input. Because the basilar membrane is graded in mass and stiffness along its length, however, each traveling wave grows in magnitude and decreases in wavelength until it peaks at a specific, frequency-dependent position: low frequencies propagate to the cochlear apex, whereas high frequencies culminate at the base. The oscillations of the basilar membrane deflect hair bundles, the mechanically sensitive organelles of the ear's sensory receptors, the hair cells. As mechanically sensitive ion channels open and close, each hair cell responds with an electrical signal that is chemically transmitted to an afferent nerve fiber and thence into the brain. In addition to transducing mechanical inputs, hair cells amplify them by two means. Channel gating endows a hair bundle with negative stiffness, an instability that interacts with the motor protein myosin-1c to produce a mechanical amplifier and oscillator. Acting through the piezoelectric membrane protein prestin, electrical responses also cause outer hair cells to elongate and shorten, thus pumping energy into the basilar membrane's movements. The two forms of motility constitute an active process that amplifies mechanical inputs, sharpens frequency discrimination, and confers a compressive nonlinearity on responsiveness. These features arise because the

  1. A Fully-Implantable Cochlear Implant SoC with Piezoelectric Middle-Ear Sensor and Arbitrary Waveform Neural Stimulation

    PubMed Central

    Yip, Marcus; Jin, Rui; Nakajima, Hideko Heidi; Stankovic, Konstantina M.; Chandrakasan, Anantha P.

    2015-01-01

    A system-on-chip for an invisible, fully-implantable cochlear implant is presented. Implantable acoustic sensing is achieved by interfacing the SoC to a piezoelectric sensor that detects the sound-induced motion of the middle ear. Measurements from human cadaveric ears demonstrate that the sensor can detect sounds between 40 and 90 dB SPL over the speech bandwidth. A highly-reconfigurable digital sound processor enables system power scalability by reconfiguring the number of channels, and provides programmable features to enable a patient-specific fit. A mixed-signal arbitrary waveform neural stimulator enables energy-optimal stimulation pulses to be delivered to the auditory nerve. The energy-optimal waveform is validated with in-vivo measurements from four human subjects which show a 15% to 35% energy saving over the conventional rectangular waveform. Prototyped in a 0.18 μm high-voltage CMOS technology, the SoC in 8-channel mode consumes 572 μW of power including stimulation. The SoC integrates implantable acoustic sensing, sound processing, and neural stimulation on one chip to minimize the implant size, and proof-of-concept is demonstrated with measurements from a human cadaver ear. PMID:26251552

  2. Pili play an important role in enhancing the bacterial clearance from the middle ear in a mouse model of acute otitis media with Moraxella catarrhalis.

    PubMed

    Kawano, Toshiaki; Hirano, Takashi; Kodama, Satoru; Mitsui, Marcelo Takahiro; Ahmed, Kamruddin; Nishizono, Akira; Suzuki, Masashi

    2013-03-01

    Moraxella catarrhalis is a Gram-negative aerobic diplococcus that is currently the third most frequent cause of bacterial acute otitis media (AOM) in children. In this study, we developed an experimental murine AOM model by inoculating M. catarrhalis in the middle ear bulla and studied the local response to this inoculation, and modulation of its course by the pili of M. catarrhalis. The pili-positive and pili-negative M. catarrhalis showed differences in bacterial clearance and infiltration of inflammatory cells in the middle ear. Pili-negative M. catarrhalis induced a more delayed and prolonged immune response in the middle ear than that of pili-positive M. catarrhalis. TLR2, -4, -5 and -9 mRNA expression was upregulated in neutrophils that infiltrated the middle ear cavity during AOM caused by both pili-positive and pili-negative bacteria. TLR5 mRNA expression and TLR5 protein in the neutrophils were induced more robustly by pili-positive M. catarrhalis. This immune response is likely to be related to neutrophil function such as toll-like 5-dependent phagocytosis. Our results show that mice may provide a useful AOM model for studying the role of M. catarrhalis. Furthermore, we show that pili play an important role in enhancing M. catarrhalis clearance from the middle ear that is probably mediated through neutrophil-dependent TLR5 signaling.

  3. Upregulation of phosphorylated HSP27, PRDX2, GRP75, GRP78 and GRP94 in acquired middle ear cholesteatoma growth.

    PubMed

    Ho, Kuen Yao; Yeh, Tai Sheng; Huang, Han Hsiang; Hung, Kuo Feng; Chai, Chee Yin; Chen, Wan Tzu; Tsai, Shih Meng; Chang, Ning Chia; Chien, Chen Yu; Wang, Hsun Mo; Wu, Yu Jen

    2013-01-01

    Cholesteatoma is a destructive and expanding growth of keratinizing squamous epithelium in the middle ear or petrous apex. The molecular and cellular processes of the pathogenesis of acquired middle ear cholesteatoma have not been fully understood. In this study, comparative proteomic analysis was conducted to investigate the roles of specific proteins in the pathways regarding keratinocyte proliferation in cholesteatoma. The differential proteins were detected by comparing the two-dimension electrophoresis (2-DE) maps of the epithelial tissues of 12 attic cholesteatomas with those of retroauricular skins. There were 14 upregulated proteins in the epithelial tissues of cholesteatoma in comparison with retroauricular skin. The modulation of five crucial proteins, HSP27, PRDX2, GRP75, GRP78 and GRP94, was further determined by RT-PCR, Western blot and immunohistochemistry. Phosphorylation of HSP27 at Ser-82 was identified by mass spectroscopy. The results of this study suggested that phosphorylated HSP27 is the end expression of two potential signal-transduction pathways, and together with PRDX2, they are very likely involved in the proliferation of keratinocytes in cholesteatoma. Upregulations of GRP75, GRP78 and GRP94 in keratinocytes may be able to counter endoplasmic reticulum stress, to inhibit cell apoptosis, to prevent protein unfolding and to promote cholesteatoma growth. PMID:23852020

  4. Closure of the middle ear with special reference to the development of the tegmen tympani of the temporal bone

    PubMed Central

    Rodríguez-Vázquez, José Francisco; Murakami, Gen; Verdugo-López, Samuel; Abe, Shin-ichi; Fujimiya, Mineko

    2011-01-01

    Closure of the middle ear is believed to be closely related to the evolutionary development of the mammalian jaw. However, few comprehensive descriptions are available on fetal development. We examined paraffin-embedded specimens of 20 mid-term human fetuses at 8–25 weeks of ovulation age (crown-rump length or CRL, 38–220 mm). After 9 weeks, the tympanic bone and the squamous part of the temporal bone, each of which was cranial or caudal to Meckel's cartilage, grew to close the lateral part of the tympanosquamosal fissure. At the same time, the cartilaginous tegmen tympani appeared independently of the petrous part of the temporal bone and resulted in the petrosquamosal fissure. Subsequently, the medial part of the tympanosquamosal fissure was closed by the descent of a cartilaginous inferior process of the tegmen tympani. When Meckel's cartilage changed into the sphenomandibular ligament and the anterior ligament of the malleus, the inferior process of the tegmen tympani interposed between the tympanic bone and the squamous part of the temporal bone, forming the petrotympanic fissure for the chorda tympani nerve and the discomalleolar ligament. Therefore, we hypothesize that, in accordance with the regression of Meckel's cartilage, the rapidly growing temporomandibular joint provided mechanical stress that accelerated the growth and descent of the inferior process of the tegmen tympani via the discomalleolar ligament. The usual diagram showing bony fissures around the tegmen tympani may overestimate the role of the tympanic bone in the fetal middle-ear closure. PMID:21477146

  5. Measurement of the vibration of the middle ear ossicles with removed eardrum: a method for quantification of ossicular fixation.

    PubMed

    Peacock, John; von Unge, Magnus; Dirckx, Joris

    2013-12-01

    Chronic inflammation of the middle ear is a common disease in which the mobility of the middle ear ossicles may be reduced; resulting in hearing impairment. Knowledge of the degree of ossicular mobility is useful in helping a surgeon determine how to proceed with treatment. In advanced cases, mobility can be assessed by manually pressing on the ossicles, but in less advanced cases manual assessment can provide limited useful information. Ossicular vibration can be measured with a laser vibrometer, but only the manubrium of the malleus is optically visible without removing the eardrum. Since the eardrum is the means by which acoustic energy is translated into the mechanical motion of the ossicles, removing it renders any subsequent measurements of ossicular motion meaningless. We therefore devised a technique in which the ossicles are vibrated magnetically. After measuring the response of the umbo to acoustic stimulation, we removed the eardrum and attached a small magnet to the manubrium. An electromagnetic excitation coil was then used to vibrate the magnet, and the signal to the coil was adjusted until the vibration of the ossicles matches that achieved acoustically. In this paper we explain the method and describe some test measurements on a vinyl membrane, and some preliminary results obtained on a fresh-frozen human temporal bone before and after artificial fixation of the ossicles.

  6. Upregulation of Phosphorylated HSP27, PRDX2, GRP75, GRP78 and GRP94 in Acquired Middle Ear Cholesteatoma Growth

    PubMed Central

    Ho, Kuen Yao; Yeh, Tai Sheng; Huang, Han Hsiang; Hung, Kuo Feng; Chai, Chee Yin; Chen, Wan Tzu; Tsai, Shih Meng; Chang, Ning Chia; Chien, Chen Yu; Wang, Hsun Mo; Wu, Yu Jen

    2013-01-01

    Cholesteatoma is a destructive and expanding growth of keratinizing squamous epithelium in the middle ear or petrous apex. The molecular and cellular processes of the pathogenesis of acquired middle ear cholesteatoma have not been fully understood. In this study, comparative proteomic analysis was conducted to investigate the roles of specific proteins in the pathways regarding keratinocyte proliferation in cholesteatoma. The differential proteins were detected by comparing the two-dimension electrophoresis (2-DE) maps of the epithelial tissues of 12 attic cholesteatomas with those of retroauricular skins. There were 14 upregulated proteins in the epithelial tissues of cholesteatoma in comparison with retroauricular skin. The modulation of five crucial proteins, HSP27, PRDX2, GRP75, GRP78 and GRP94, was further determined by RT-PCR, Western blot and immunohistochemistry. Phosphorylation of HSP27 at Ser-82 was identified by mass spectroscopy. The results of this study suggested that phosphorylated HSP27 is the end expression of two potential signal-transduction pathways, and together with PRDX2, they are very likely involved in the proliferation of keratinocytes in cholesteatoma. Upregulations of GRP75, GRP78 and GRP94 in keratinocytes may be able to counter endoplasmic reticulum stress, to inhibit cell apoptosis, to prevent protein unfolding and to promote cholesteatoma growth. PMID:23852020

  7. Possible role of interleukin 1 alpha and interleukin 1 beta in the pathogenesis of cholesteatoma of the middle ear.

    PubMed

    Schilling, V; Negri, B; Bujía, J; Schulz, P; Kastenbauer, E

    1992-07-01

    Cholesteatoma of the middle ear is characterized by the presence of hyperproliferative keratinizing squamous epithelium in the middle ear cavity and destruction of adjacent bone. Interleukin 1 (IL-1) is an autocrine growth factor for normal keratinocytes and is capable of inducing bone degradation. The distribution of two molecular species of IL-1, IL-1 alpha and IL-1 beta, was investigated immunohistochemically in the hyperproliferative epithelium of cholesteatoma, in normal epidermis of the auditory canal and of the retroauricular region, and in nonkeratinizing tonsillar epithelium. In all squamous epithelia examined, IL-1 alpha and IL-1 beta were present in comparable amounts. The IL-1 content of cholesteatoma epithelium was clearly increased in relation to normal skin keratinocytes. All cellular layers of cholesteatoma epithelium stained strongly and uniformly for Il-1 alpha and IL-1 beta, whereas the keratin layer was negative for IL-1. No particularly strong reaction with basal cells was detected. In the connective tissue under the squamous epithelium of cholesteatoma, intensely positive cells were scattered between negative stromal cells. Our results suggest that IL-1 could be liberated from disintegrating keratinocytes and cells of the monocyte-macrophage lineage, stimulate the proliferation of the cholesteatoma epithelium in an autocrine manner, and contribute to the enhancement of bone destruction in the presence of cholesteatoma.

  8. [Investigation of viral nucleic acids in middle-ear effusion specimens from children with acute otitis media].

    PubMed

    Abu Sitteh, Muhammed H; Sener, Kenan; Yapar, Mehmet; Kiliç, Abdullah; Güney, Cakir; Kubar, Ayhan

    2008-07-01

    Acute otitis media with effusion (OME) is one of the major causes of antibiotic use, indication for operation and hearing loss in children. In two third of the cases the etiologic agents are bacteria. Nonetheless, increasing numbers of reports have implicated viruses as etiologic agents that may have some effect on prognosis of OME. The aim of this study was to investigate the presence of nucleic acids of respiratory syncytial virus (RSV) type A and B, influenza type A virus, adenovirus, cytomegalovirus (CMV), herpes simplex virus type-1 (HSV-1), and enteroviruses in the middle ear effusion specimens from children with otitis media by TaqMan real-time PCR. As a result, 18 of 30 (60%) OME samples were found positive in terms of viral nucleic acids by real-time PCR. RSV-A was detected in nine samples (30%), CMV in 3 (10%) samples and HSV-1 in 1 (3.3%) sample. In five of the samples two viruses were detected in the same sample (three were positive for adenovirus and RSV-A, and two were positive for CMV and RSV-A). Our data have supported the importance of viruses as etiologic agents of OME. Additionally, it was thought that TaqMan real-time PCR may be used as a reliable and rapid method for the detection of viruses in the middle ear effusion samples.

  9. Sing It, Hear It, Play It! Ear Training for Middle School Students.

    ERIC Educational Resources Information Center

    Huenink, Jeffrey S.

    2002-01-01

    Discusses how to increase student skills in ear training. Offers suggestions used with fifth through eighth grade band students, such as sing with your bands or teach the band solfege syllables. Includes a list of songs, research resources, and tonal patterns. (CMK)

  10. The biological performance of calcium phosphate ceramics in an infected implantation site. III: Biological performance of beta-whitlockite in the noninfected and infected rat middle ear.

    PubMed

    van Blitterswijk, C A; Grote, J J; Koerten, H K; Kuijpers, W

    1986-10-01

    The biological performance of macroporous beta-whitlockite implanted in the rat middle ear was evaluated. The material was studied in the non-infected middle ear and in middle ears infected by Staphylococcus aureus. beta-whitlockite was quickly covered by a normal mucosa. One week post-operatively the macropores were filled with exudate, fibrous tissue, and a small quantity of bone. Six months after the operation the greater part of the macropore area was filled with bone (74%); fibrous tissue accounted for 20%, and exudate for 5%. In histological sections, the macropore area of beta-whitlockite had increased by 68% after six months, indicating biodegradation. Macrophages and multinucleated cells were present in the vicinity of the implant and played a role in this biodegradation. Besides cytoplasmic vacuoles containing calcium phosphate, the cells showed smaller granules containing trace elements originally present in the implant material, such as silicon, titanium, aluminum, iron, and magnesium. PMID:3023387

  11. Middle and inner ear malformations in mutation-proven branchio-oculo-facial (BOF) syndrome: case series and review of the literature.

    PubMed

    Carter, Melissa T; Blaser, Susan; Papsin, Blake; Meschino, Wendy; Reardon, Willie; Klatt, Regan; Babul-Hirji, Riyana; Milunsky, Jeff; Chitayat, David

    2012-08-01

    Hearing impairment is common in individuals with branchio-oculo-facial (BOF) syndrome. The majority of described individuals have conductive hearing impairment due to malformed ossicles and/or external canal stenosis or atresia, although a sensorineural component to the hearing impairment in BOF syndrome is increasingly being reported. Sophisticated computed tomography (CT) of the temporal bone has revealed middle and inner ear malformations in three previous reports. We present middle and inner ear abnormalities in three additional individuals with mutation-proven BOF syndrome. We suggest that temporal bone CT imaging be included in the medical workup of a child with BOF syndrome, in order to guide management.

  12. [Significance of tube manometry in the assessment of tube function. A comparison of tube manometry results and continuous direct determination of pressure in the middle ear].

    PubMed

    Koch, U

    1983-04-01

    Tube manometry--also known as aspiration-deflation-test--is an often used, practicable clinical test for tube function. By comparing tube manometric results with continual measurements of the middle ear pressure, a close correlation between both test results could be demonstrated. Tube manometric tests thus permit an estimation of the tube function as well as of the probable development of the middle ear pressure. An exact classification in terms of physiologic and pathologic tube function, however, is not possible. It is clear that even a partial equalization of low-pressure values in tube manometry should be interpreted as physiologic.

  13. Inner ear hearing loss modulates ipsilateral temporal lobe activation by monaural speech stimuli.

    PubMed

    Tateya, Ichiro; Naito, Yasushi; Hirano, Shigeru; Kojima, Hisayoshi; Inoue, Masato; Kaneko, Ken-Ichi; Toyoda, Hiroshi; Ueno, Makoto; Ishizu, Koichi; Ito, Juichi

    2003-04-15

    We examined cortical activation by speech in patients with moderate inner ear hearing loss using PET to investigate the response of the language network to insufficient speech input. We made two word lists, well-perceived words and poorly-perceived words, and measured rCBF during monaural presentation of these words. Well-perceived words activated bilateral temporal lobes, bilateral inferior frontal gyri (IFG) and left angular gyrus (AG) regardless of the ear stimulated, Poorly-perceived words activated contralateral temporal lobe and bilateral IFG, while little or no activation was observed in the ipsilateral temporal lobe and left AG. Insufficient activation of the temporal lobe ipsilateral to the ear stimulated might correlated with less accurate word comprehension in patients with inner ear hearing loss.

  14. Good transfer of tebipenem into middle ear effusion conduces to the favorable clinical outcomes of tebipenem pivoxil in pediatric patients with acute otitis media.

    PubMed

    Sugita, Rinya

    2013-06-01

    Tebipenem pivoxil, an oral carbapenem antibiotic for pediatric use, exhibits excellent clinical effects on acute otitis media (AOM). The present study was conducted to assess the pharmacokinetic profile of tebipenem in middle ear effusion and to examine the clinical efficacy of tebipenem pivoxil by calculating the values of the pharmacokinetic-pharmacodynamic parameters (AUC/MIC, C max/MIC, and T > MIC) of tebipenem at the site of action. Twenty-three pediatric outpatients diagnosed with AOM were enrolled. Ear discharge or nasopharyngeal swabs collected before the onset of oral administration were used to conduct bacteriological examinations, and subjects were then treated by twice-a-day oral administration of tebipenem pivoxil 6 mg/kg. The clinical isolates of Streptococcus pneumoniae and Haemophilus influenzae were obtained from 10 and 19 pediatric patients (8 overlapped), respectively. On day 2 of administration, blood and middle ear effusion were collected from 20 pediatric patients to measure plasma and middle ear concentrations of tebipenem. Consequently, the C max and the AUC0-∞ in plasma were 5.3 ± 1.6 μg/ml (mean ± SD) and 7.9 ± 0.2 μg h/ml, respectively. The C max in middle ear effusion of tebipenem was 1.2 ± 0.1 μg/ml, exceeding its MIC for these pathogens. The ratio of AUC0-∞ in middle ear effusion to AUC0-∞ in plasma was 0.36, showing the good transfer of tebipenem into the effusion; this result corroborated the known high rate of clinical efficacy of tebipenem pivoxil for patients with AOM and the low incidence of recurrence in them as manifested by the healing rate of 94.1 % (16/17). PMID:23393013

  15. Developmental changes in word recognition threshold from two to five years of age in children with different middle ear status.

    PubMed

    Hall, Amanda J; Munro, Kevin J; Heron, Jon

    2007-07-01

    The aims were to: (1) provide word recognition thresholds (WRTs) at 31, 43, and 61 months of age; (2) investigate developmental changes over time; (3) investigate the relationship between OME and WRT, and (4) investigate the relationship between WRT and hearing thresholds. Around 1000 children were tested longitudinally as part of the ALSPAC study, using an adaptive measure of word recognition in quiet. Mean WRTs were 28, 23, and 23 dB (A) at 31, 43, and 61 months, respectively. Normal auditory development is associated with a mean improvement in WRT of 5 dB between age 31 and 61 months. There was a mean increase in WRT of +5 dB and +15 dB when OME was present in one and two ears, respectively. Thus, both unilateral and bilateral OME results in a detrimental effect on hearing ability for speech. Additionally, early and 'persistent' OME is associated with greater disability. However by 61 months, previous OME status was not significant. To our knowledge, this is the largest longitudinal study reporting WRT in preschool children with different middle ear status. PMID:17680467

  16. Giant Cell Tumor of the Temporal Bone with Direct Invasion into the Middle Ear and Skull Base: A Case Report

    PubMed Central

    Iizuka, Takashi; Furukawa, Masayuki; Ishii, Hisato; Kasai, Misato; Hayashi, Chieri; Arai, Hajime; Ikeda, Katsuhisa

    2012-01-01

    Giant cell tumor (GCT) is classified as a benign bone tumor, and it is frequently identified at the epiphysis of long bones and relatively rare in the temporal bone. For orthopedists expert at recognizing bone and soft tissue tumors, the diagnosis of GCT is relatively easy; however, since head and neck surgeons experience few cases of GCT, it may be difficult to diagnose when it occurs in the temporal bone. A 32-year-old man complained of left hearing loss, aural fullness, and tinnitus. Examination of the ear revealed a bulging tumor. Audiologic examination demonstrated conductive hearing loss of the left ear. Computer tomograph of the temporal bone showed a soft-tissue-density specification indicating bone destruction at the left temporal bone. The tumor invaded the skull base. Imaging examinations using magnetic resonance imaging revealed a nonhomogenous isosignal intensity area on T1 at the left temporal bone. After intravenous gadolinium, the mass showed unequal enhancement. This patient subsequently underwent surgery to remove the lesion using transmastoid and middle fossa approach. Pathological examinations from specimens of the tumor revealed characteristic of GCT. No clinical or radiological evidence of tumor recurrence was detected for 4 years. PMID:22953120

  17. Intracranial invasion from a primary adenocarcinoma arising in the middle and external ear.

    PubMed

    McDonald, M; Brophy, B P; Raymond, W

    1995-06-01

    Cerumenal adenocarcinoma is a rare neoplasm arising from the modified sweat glands of the ear. Before the diagnosis of primary tumour is made, a thorough search must be undertaken to exclude the possibility of metastatic disease, which occurs more commonly. Benign adenoma can also occur and this may be identical histologically to the malignant variety. The presence of local invasiveness may be the only differentiating feature. Aggressive local resection followed by postoperative radiotherapy form the cornerstone of management. Individuals treated with radiotherapy alone have a life expectancy of less than 12 months whereas cures have been reported with radical surgery.

  18. Individual use of antibiotics and prevalence of beta-lactamase production among bacterial pathogens from middle ear fluid.

    PubMed

    Thrane, N; Olesen, C; Sørensen, H T; Schønheyder, H C

    2001-02-01

    Prescription data and clinical laboratory data were analysed to assess the influence of previous antibiotic therapy on the prevalence of beta-lactamase in isolates of Haemophilus influenzae and Moraxella catarrhalis from primary specimens of middle ear fluid from 2129 children aged 0-5 years. The prevalence of beta-lactamase-positive H. influenzae was 6.6% [95% confidence interval (CI): 3.5-9.8%] in children who received antibiotics 5-90 days before isolation of the organism compared with 7.0% (95% CI: 3.9-10.2%) in those who did not. The prevalence of beta-lactamase-positive M. catarrhalis was 90.9% (95% CI: 84.0-97.8%) in children who received antibiotics compared with 86.7% (95% CI: 79.0-94.4%) in those who did not.

  19. Mammomonogamus auris infection in the middle ear of a domestic cat in Saipan, Northern Mariana Islands, USA.

    PubMed

    Tudor, Edgar G; Lee, Alice C Y; Armato, Danielle G; Bowman, Dwight D

    2008-10-01

    A 2-year-old female domestic shorthair cat on the island of Saipan was presented to a local veterinarian for headshaking. Otoscopic examination showed mild erythema of the right tympanic membrane, but was otherwise unremarkable. Headshaking resolved with topical gentamicin/betamethasone/clotrimazole therapy; however, erythema persisted. Further otoscopy revealed movement of the erythematous region, which was in fact the red-colored strongylid nematode, Mammomonogamus auris, residing within the middle ear. Myringotomy and a saline flush were performed under heavy sedation. A silastic tube was inserted into the incision and the worms were retrieved by applying negative pressure. Follow-up treatment included topical thiabendazole/dexamethasone/neomycin ointment as well as selamectin. Mammomonogamus auris has previously been documented only three times, once each in China, Sri Lanka and Japan. This is the first report of M auris in cats from Saipan.

  20. The effect of flying and low humidity on the admittance of the tympanic membrane and middle ear system.

    PubMed

    Morse, Robert Peter

    2013-10-01

    Many passengers experience discomfort during flight because of the effect of low humidity on the skin, eyes, throat, and nose. In this physiological study, we have investigated whether flight and low humidity also affect the tympanic membrane. From previous studies, a decrease in admittance of the tympanic membrane through drying might be expected to affect the buffering capacity of the middle ear and to disrupt automatic pressure regulation. This investigation involved an observational study onboard an aircraft combined with experiments in an environmental chamber, where the humidity could be controlled but could not be made to be as low as during flight. For the flight study, there was a linear relationship between the peak compensated static admittance of the tympanic membrane and relative humidity with a constant of proportionality of 0.00315 mmho/% relative humidity. The low humidity at cruise altitude (minimum 22.7 %) was associated with a mean decrease in admittance of about 20 % compared with measures in the airport. From the chamber study, we further found that a mean decrease in relative humidity of 23.4 % led to a significant decrease in mean admittance by 0.11 mmho [F(1,8) = 18.95, P = 0.002], a decrease of 9.4 %. The order of magnitude for the effect of humidity was similar for the flight and environmental chamber studies. We conclude that admittance changes during flight were likely to have been caused by the low humidity in the aircraft cabin and that these changes may affect the automatic pressure regulation of the middle ear during descent. PMID:23887775

  1. The effect of flying and low humidity on the admittance of the tympanic membrane and middle ear system.

    PubMed

    Morse, Robert Peter

    2013-10-01

    Many passengers experience discomfort during flight because of the effect of low humidity on the skin, eyes, throat, and nose. In this physiological study, we have investigated whether flight and low humidity also affect the tympanic membrane. From previous studies, a decrease in admittance of the tympanic membrane through drying might be expected to affect the buffering capacity of the middle ear and to disrupt automatic pressure regulation. This investigation involved an observational study onboard an aircraft combined with experiments in an environmental chamber, where the humidity could be controlled but could not be made to be as low as during flight. For the flight study, there was a linear relationship between the peak compensated static admittance of the tympanic membrane and relative humidity with a constant of proportionality of 0.00315 mmho/% relative humidity. The low humidity at cruise altitude (minimum 22.7 %) was associated with a mean decrease in admittance of about 20 % compared with measures in the airport. From the chamber study, we further found that a mean decrease in relative humidity of 23.4 % led to a significant decrease in mean admittance by 0.11 mmho [F(1,8) = 18.95, P = 0.002], a decrease of 9.4 %. The order of magnitude for the effect of humidity was similar for the flight and environmental chamber studies. We conclude that admittance changes during flight were likely to have been caused by the low humidity in the aircraft cabin and that these changes may affect the automatic pressure regulation of the middle ear during descent.

  2. Forward and reverse transfer functions of the middle ear based on pressure and velocity DPOAEs with implications for differential hearing diagnosis.

    PubMed

    Dalhoff, Ernst; Turcanu, Diana; Gummer, Anthony W

    2011-10-01

    Recently it was shown that distortion product otoacoustic emissions (DPOAEs) can be measured as vibration of the human tympanic membrane in vivo, and proposed to use these vibration DPOAEs to support a differential diagnosis of middle-ear and cochlear pathologies. Here, we investigate how the reverse transfer function (r-TF), defined as the ratio of DPOAE-velocity of the umbo to DPOAE-pressure in the ear canal, can be used to diagnose the state of the middle ear. Anaesthetized guinea pigs served as the experimental animal. Sound was delivered free-field and the vibration of the umbo measured with a laser Doppler vibrometer (LDV). Sound pressure was measured 2-3 mm from the tympanic membrane with a probe-tube microphone. The forward transfer function (f-TF) of umbo velocity relative to ear-canal pressure was obtained by stimulating with multi-tone pressure. The r-TF was assembled from DPOAE components generated in response to acoustic stimulation with two stimulus tones of frequencies f(1) and f(2); f(2)/f(1) was constant at 1.2. The r-TF was plotted as function of DPOAE frequencies; they ranged from 1.7 kHz to 23 kHz. The r-TF showed a characteristic shape with an anti-resonance around 8 kHz as its most salient feature. The data were interpreted with the aid of a middle-ear transmission-line model taken from the literature for the cat and adapted to the guinea pig. Parameters were estimated with a three-step fitting algorithm. Importantly, the r-TF is governed by only half of the 15 independent, free parameters of the model. The parameters estimated from the r-TF were used to estimate the other half of the parameters from the f-TF. The use of r-TF data - in addition to f-TF data - allowed robust estimates of the middle-ear parameters to be obtained. The results highlight the potential of using vibration DPOAEs for ascertaining the functionality of the middle ear and, therefore, for supporting a differential diagnosis of middle-ear and cochlear pathologies. PMID

  3. Notes on the Diet of Reproductively Active Male Rafinesque's Big Eared Bats

    SciTech Connect

    Menzel, M.A.; Carter, T.C.; Menzel, J.M.; Edwards, J.W.; Ford, W.M.

    2002-01-01

    Diet examination through the use of fecal samples, of five reproductively active male Rafinesque's big-eared bats from the Upper Coastal Plain of South Carolina during August and September 1999. Diets of these individuals in upland pine stands were similar to diets of Rafinesque's big-eared bats in bottomland and upland hardwood habitats. Although fecal samples had three insect orders, the diet consisted primarily of lepidopterans.

  4. Early Adolescence: Active Science for Middle Schoolers.

    ERIC Educational Resources Information Center

    Padilla, Michael; Griffin, Nancy

    1980-01-01

    Describes activities appropriate for involving middle school students as active participants in the learning process. Topics discussed include archaeology, bulletin boards, dramatizations, physics experiments using the human body, oceanography, and ecology. (CS)

  5. The Electrical Activity of a Denervated Ear 1

    PubMed Central

    Rawdon-Smith, A. F.; Hawkins, J. E.

    1939-01-01

    The electrical response from the cochlea of a cat which had previously been denervated by intracranial crushing of the auditory nerve was submitted to a lengthy study, the results of which may be summarized as follows:- The responses to acoustical stimulation derived from electrodes placed on the round window margin and in the chin muscles were studied by means of an amplifier and cathode ray oscillograph, in the usual way. Transient stimuli whose polarity could be reversed were employed to demonstrate the absence of any electrical component of neural origin such as is invariably present in a normal ear. In all other respects, however, the responses were unaffected, and both threshold contours (the so-called “electrical audiogram”) and equal response contours for approximately pure-tone stimuli demonstrated close comparability with those for normal ears. Harmonic analysis of the cochlear response yielded results departing from the normal only in such respects as would be expected in view of the complete absence of nervous component in the analysed wave. From these data, it is argued that this animal presented a case in which normal electrical responses were obtained from the peripheral organ, despite virtually complete degeneration of the auditory nerve, and, it follows, complete unilateral deafness. Subsequent histological examination confirmed these observations, and it is urged, therefore, that the validity of the view that the cochlear response provides an index of the hearing ability of an animal, as is sometimes stated, is open to question. Additionally, this experiment finally discredits the hypothesis that the cochlear response itself is, in any sense, neural in origin; it further indicates the necessity for caution in the interpretation of results obtained from normal ears, where the cochlear response, however derived, is in some degree adulterated by the simultaneous presence of an action potential component. ImagesFig. 8 PMID:19991849

  6. The relationship between active hand and ear advantage in the native and foreign language.

    PubMed

    Mildner, Vesna; Stanković, Davor; Petković, Marina

    2005-03-01

    In an experimental design involving two auditorily presented competing commands (one to each ear), 144 right-handed subjects (72 male and 72 female) were asked to provide motor responses. Half of each group of subjects was responding with their right hand and the other half with the left. The test was applied in the subjects' native language (Croatian) and in English, which they had learned as a foreign language. Ear advantage was determined by calculating laterality indices from the order of responding to the commands. On average, right-ear advantage was found in all conditions. Analysis of results revealed the effect of the active hand in Croatian (with significant decrease in the right-ear advantage when using the left hand). The same trend failed to reach significance in English. In responses to English stimuli, there was a significant effect of gender (with men exhibiting a lower right-ear advantage than women). The same trend was not significant for Croatian stimuli. The consistently lower right-ear advantage found in male subjects is contrary to the traditional assumptions that men are more lateralized than women and warrants further investigation.

  7. Distribution of esterase activity in porcine ear skin, and the effects of freezing and heat separation.

    PubMed

    Lau, Wing Man; Ng, Keng Wooi; Sakenyte, Kristina; Heard, Charles M

    2012-08-20

    Porcine ear skin is widely used to study skin permeation and absorption of ester compounds, whose permeation and absorption profiles may be directly influenced by in situ skin esterase activity. Importantly, esterase distribution and activity in porcine ear skin following common protocols of skin handling and storage have not been characterised. Thus, we have compared the distribution and hydrolytic activity of esterases in freshly excised, frozen, heated and explanted porcine ear skin. Using an esterase staining kit, esterase activity was found to be localised in the stratum corneum and viable epidermis. Under frozen storage and a common heating protocol of epidermal sheet separation, esterase staining in the skin visibly diminished. This was confirmed by a quantitative assay using HPLC to monitor the hydrolysis of aspirin, in freshly excised, frozen or heated porcine ear skin. Compared to vehicle-only control, the rate of aspirin hydrolysis was approximately three-fold higher in the presence of freshly excised skin, but no different in the presence of frozen or heated skin. Therefore, frozen and heat-separated porcine ear skin should not be used to study the permeation of ester-containing permeants, in particular co-drugs and pro-drugs, whose hydrolysis or degradation can be modulated by skin esterases.

  8. Pierced Ears

    MedlinePlus

    ... Homework? Here's Help White House Lunch Recipes Pierced Ears KidsHealth > For Kids > Pierced Ears Print A A ... cool, but infected ears do not! Getting Your Ears Pierced It's important to get your ears pierced ...

  9. A tympanal insect ear exploits a critical oscillator for active amplification and tuning.

    PubMed

    Mhatre, Natasha; Robert, Daniel

    2013-10-01

    A dominant theme of acoustic communication is the partitioning of acoustic space into exclusive, species-specific niches to enable efficient information transfer. In insects, acoustic niche partitioning is achieved through auditory frequency filtering, brought about by the mechanical properties of their ears. The tuning of the antennal ears of mosquitoes and flies, however, arises from active amplification, a process similar to that at work in the mammalian cochlea. Yet, the presence of active amplification in the other type of insect ears--tympanal ears--has remained uncertain. Here we demonstrate the presence of active amplification and adaptive tuning in the tympanal ear of a phylogenetically basal insect, a tree cricket. We also show that the tree cricket exploits critical oscillator-like mechanics, enabling high auditory sensitivity and tuning to conspecific songs. These findings imply that sophisticated auditory mechanisms may have appeared even earlier in the evolution of hearing and acoustic communication than currently appreciated. Our findings also raise the possibility that frequency discrimination and directional hearing in tympanal systems may rely on physiological nonlinearities, in addition to mechanical properties, effectively lifting some of the physical constraints placed on insects by their small size [6] and prompting an extensive reexamination of invertebrate audition.

  10. Intraoperative radiation therapy as adjuvant treatment in locally advanced stage tumours involving the middle ear: a hypothesis-generating retrospective study.

    PubMed

    Cristalli, G; Mercante, G; Marucci, L; Soriani, A; Telera, S; Spriano, G

    2016-04-01

    The objective of this study was to evaluate the safety, effectiveness and functional outcomes of intraoperative radiotherapy (IORT) followed by intensity-modulated radiation therapy (IMRT) in locally advanced stage tumours involving the middle ear. Data on 13 consecutive patients treated for malignant tumor of external auditory canal involving the middle ear were retrospectively reviewed. Median follow-up was 33 months (range 6-133). Five (38%) patients were stage III and 8 (62%) were Stage IV according to the University of Pittsburgh staging system. Lateral temporal bone resection (LTBR) was performed in all cases. LTBR was associated with parotidectomy in 5 (38%) cases, and with neck dissection and parotidectomy in 6 (46%) cases. No patients had gross residual tumour. Surgical treatment was followed by IORT (12 Gy) and IMRT (50 Gy). Adjuvant chemotherapy was used in 4 (30%) cases. Preoperative and postoperative audiometric tests were performed to assess hearing loss. 5-year local-control (LC), 5-year distant-metastasis (DM), 5-year disease-free-survival (DFS) and 5-year overall-survival (OS) were calculated with Kaplan-Meyer method. Significant changes in bone conduction were reported after treatment. Partial flap necrosis was the only early complication observed in three (23%) cases, while meningeal fistula was seen in one (7.6%) case as a late complication. The 5-year LC-rate was 68%. The 5-year DM-rate was 90%. The 5-year DFS-rate was 61%. The 5-year OS-rate was 69%. IORT followed by IMRT for the treatment of advanced external auditory canal and middle ear tumours seems to be safe. No intraoperative death was reported. IORT may reduce the postoperative irradiation of remnant tissue obtaining the same full dose on the tumour bed. No complications of the residual external ear were observed. Detriment of neurosensory hearing may be expected. Future studies are required to confirm the benefit of this procedure in the ear.

  11. Details of human middle ear morphology based on micro-CT imaging of phosphotungstic acid stained samples.

    PubMed

    De Greef, Daniel; Buytaert, Jan A N; Aerts, Johan R M; Van Hoorebeke, Luc; Dierick, Manuel; Dirckx, Joris

    2015-09-01

    A multitude of morphological aspects of the human middle ear (ME) were studied qualitatively and/or quantitatively through the postprocessing and interpretation of micro-CT (micro X-ray computed tomography) data of six human temporal bones. The samples were scanned after phosphotungstic acid staining to enhance soft-tissue contrast. The influence of this staining on ME ossicle configuration was shown to be insignificant. Through postprocessing, the image data were converted into surface models, after which the approaches diverged depending on the topics of interest. The studied topics were: the ME ligaments; morphometric and mechanical parameters of the ossicles relating to inertia and the ossicular lever arm ratio; the morphology of the distal incus; the contact surface areas of the tympanic membrane (TM) and of the stapes footplate; and the thickness of the TM, round window of the cochlea, ossicle joint spaces, and stapedial annular ligament. Some of the resulting insights are relevant in ongoing discussions concerning ME morphology and mechanical functions, while other results provide quantitative data to add to existing data. All findings are discussed in the light of other published data and many are relevant for the construction of mechanical finite element simulations of the ME.

  12. Otopathogens Detected in Middle Ear Fluid Obtained during Tympanostomy Tube Insertion: Contrasting Purulent and Non-Purulent Effusions

    PubMed Central

    Holder, Robert C.; Kirse, Daniel J.; Evans, Adele K.; Whigham, Amy S.; Peters, Timothy R.; Poehling, Katherine A.; Swords, William E.; Reid, Sean D.

    2015-01-01

    Otitis media is a prominent disease among children. Previous literature indicates that otitis media is a polymicrobial disease, with Haemophilus influenzae, Streptococcus pneumoniae, Alloiococcus otitidis and Moraxella catarrhalis being the most commonly associated bacterial pathogens. Recent literature suggests that introduction of pneumococcal conjugate vaccines has had an effect on the etiology of otitis media. Using a multiplex PCR procedure, we sought to investigate the presence of the aforementioned bacterial pathogens in middle ear fluid collected from children undergoing routine tympanostomy tube placement at Wake Forest Baptist Medical Center during the period between January 2011 and March 2014. In purulent effusions, one or more bacterial organisms were detected in ~90% of samples. Most often the presence of H. influenzae alone was detected in purulent effusions (32%; 10 of 31). In non-purulent effusions, the most prevalent organism detected was A. otitidis (26%; 63 of 245). Half of the non-purulent effusions had none of these otopathogens detected. In purulent and non-purulent effusions, the overall presence of S. pneumoniae was lower (19%; 6 of 31, and 4%; 9 of 245, respectively) than that of the other pathogens being identified. The ratio of the percentage of each otopathogen identified in purulent vs. non-purulent effusions was >1 for the classic otopathogens but not for A. otitidis. PMID:26039250

  13. Electrophysiological aspects of the middle ear muscle reflex in the rat: latency, rise time and effect on sound transmission.

    PubMed

    van den Berge, H; Kingma, H; Kluge, C; Marres, E H

    1990-10-01

    The latency, the rise time and the influence of the acoustic reflex on sound transmission were investigated in the adult rat during ketamin anesthesia. This was done by recordings of the cochlear microphonics (CM) and electromyographic (EMG) recordings of the reflex responses of the tensor tympani muscle. The acoustic reflex was elicited by contralateral acoustic stimuli of which the intensity and frequency was varied. Ipsilaterally, the effect on sound transmission was determined by estimating the change in amplitude of the CM's of ipsilateral administered subliminal stimuli. It was shown that both the tensor tympani muscle and the stapedius muscle contribute in the reflex. The latency as well as the rise time of the reflex determined by CM recordings showed to be short (minimal values: 12 and 7 ms respectively). The mean latency of the tensor tympani muscle reflex, measured by EMG, was about 7 ms. The attenuation of 0.25-8 kHz tone bursts upto 115 dB SPL is limited to a mean maximum of 15 dB SPL. The maximal attenuation was shown to occur at 1 kHz. Frequencies above 2 kHz appeared to be the best elicitor of the middle ear muscle reflex.

  14. Fluorescence "in situ" hybridization for the detection of biofilm in the middle ear and upper respiratory tract mucosa.

    PubMed

    Nistico, Laura; Gieseke, Armin; Stoodley, Paul; Hall-Stoodley, Luanne; Kerschner, Joseph E; Ehrlich, Garth D

    2009-01-01

    Most chronic bacterial infections are associated with biofilm formation wherein the bacteria attach to mucosal surfaces, wound tissue, or medical device surfaces in the human body via the formation of an extracellular matrix. Biofilms assume complex three-dimensional structures dependent on the species, the strain, and the prevailing environmental conditions and are composed of both the bacteria and the extracellular slime-like matrices, which surround the bacteria. Bacteria deep in the biofilm live under anaerobic conditions and must use alternatives to O(2) as a terminal electron acceptor. Thus, the metabolic rates of these deep bacteria are greatly reduced, which renders them extremely resistant to antibiotic treatment, and for reasons not clearly understood, it is often very difficult to culture biofilm bacteria using traditional microbiologic techniques. To directly identify and visualize biofilm bacteria in a species-specific manner, we developed a confocal laser scanning microscopy (CLSM)-based 16S rRNA fluorescence in situ hybridization (FISH) protocol, to find biofilm bacteria in middle ear and upper respiratory tract mucosa, which preserves the three-dimensional structure of the biofilm and avoids the use of traditional culture techniques.

  15. Pediatric Obesity and Ear, Nose, and Throat Disorders

    MedlinePlus

    ... an ENT Doctor Near You Pediatric Obesity and Ear, Nose, and Throat Disorders Pediatric Obesity and Ear, ... all children be regularly screened for snoring. Middle ear infections Acute otitis media (AOM) and chronic ear ...

  16. Minimal biofilm eradication concentration of antimicrobial agents against nontypeable Haemophilus influenzae isolated from middle ear fluids of intractable acute otitis media.

    PubMed

    Takei, Shin; Hotomi, Muneki; Yamanaka, Noboru

    2013-06-01

    Nontypeable Haemophilus influenzae (NTHi) makes the clinical course of acute otitis media (AOM) intractable by forming a biofilm that may hamper the clearance of the bacteria from middle ear cavity. In this study, we evaluated the minimum biofilm eradication concentration (MBEC) of antimicrobial agents against biofilm-forming NTHi strains. Twelve NTHi strains isolated from middle ear fluids of Japanese children with intractable AOM before antimicrobial treatment were evaluated for MBEC of fluoroquinolones in comparison with those of β-lactams and macrolides. AMPC and CDTR required much higher concentration, i.e., high MBECs, to suppress the biofilm formation of NTHi. In contrast, fluoroquinolones followed by macrolides showed lower MBECs. MBEC would be a good parameter to infer the efficacies of antimicrobials against NTHi in biofilm.

  17. Minimal biofilm eradication concentration of antimicrobial agents against nontypeable Haemophilus influenzae isolated from middle ear fluids of intractable acute otitis media.

    PubMed

    Takei, Shin; Hotomi, Muneki; Yamanaka, Noboru

    2013-06-01

    Nontypeable Haemophilus influenzae (NTHi) makes the clinical course of acute otitis media (AOM) intractable by forming a biofilm that may hamper the clearance of the bacteria from middle ear cavity. In this study, we evaluated the minimum biofilm eradication concentration (MBEC) of antimicrobial agents against biofilm-forming NTHi strains. Twelve NTHi strains isolated from middle ear fluids of Japanese children with intractable AOM before antimicrobial treatment were evaluated for MBEC of fluoroquinolones in comparison with those of β-lactams and macrolides. AMPC and CDTR required much higher concentration, i.e., high MBECs, to suppress the biofilm formation of NTHi. In contrast, fluoroquinolones followed by macrolides showed lower MBECs. MBEC would be a good parameter to infer the efficacies of antimicrobials against NTHi in biofilm. PMID:23549738

  18. Communicative Activities for Middle School Classrooms

    ERIC Educational Resources Information Center

    Rivera, Carolina

    2006-01-01

    Middle school teachers often attend seminars and workshops where the advantages of communicative activities are discussed at great length. Teachers may even enjoy doing the communicative activities themselves during a teacher training session. However, many teachers are afraid to use communicative activities in the classroom. In theory teachers…

  19. Evaluation of the Interleukin-1 Receptor Antagonist and Immunoregulatory Interleukin-10 in the Middle Ear in Chronic Otitis Media With Effusion in Children With and Without Atopy

    PubMed Central

    Zielnik-Jurkiewicz, Beata; Stankiewicz-Szymczak, Wanda

    2016-01-01

    Objectives The role of pro-inflammatory cytokines in the course of chronic otitis media with effusion (COME) has been documented. However, there are fewer studies on the action of anti-inflammatory cytokines in the middle ear. We sought determine whether there is an association between COME and anti-inflammatory cytokines and whether there are any differences in the cytokine profile in COME children with and without atopy. Methods Eighty-four children were divided into 3 groups: 32 nonatopic children with COME (group NA), 31 atopic children with COME (group A), and 21 children without COME and without atopy (control group C). Specimens from the middle ear were collected and evaluated by enzyme-linked immunosorbent assay for the cytokines interleukin-1 receptor antagonist (IL-1Ra) and immunoregulatory IL-10. Results Significantly higher IL-10 concentrations were found in both nonatopic and atopic children with COME compared to controls. No significant differences in IL-1Ra levels were found between atopic and nonatopic children with COME and the control group. Conclusion We found no differences in the levels of IL-1Ra in atopic and nonatopic children with COME compared to controls. However, we found elevated IL-10 levels in the middle ear effusions from children with COME, with or without atopy. These elevated immunoregulatory cytokine levels suggest a role for new immunomodulatory treatments to prevent disease progression in COME, regardless of atopy. PMID:27090281

  20. An Incus-Body Driving Type Piezoelectric Middle Ear Implant Design and Evaluation in 3D Computational Model and Temporal Bone

    PubMed Central

    Rao, Zhushi; Huang, Xinsheng; Cheng, Gang; Tian, Jiabin; Ta, Na

    2014-01-01

    A new incus-body driving type transducer relying on piezoelectric stack, with broad frequency bandwidth, is proposed for use in a middle ear implant. To aid the design process of this transducer, a coupling biomechanical model of the human middle ear and the piezoelectric transducer was established by reverse engineering technology. The validity of this model was confirmed by comparing model predicted motions with experimental measurements. Based on this verified biomechanical model, the main parameters of the transducer were determined. And its power consumption was calculated. Finally, to verify the capability of the designed piezoelectric transducer, a human temporal bone experimental platform was built. And the dynamic characteristics and the stimulated performance of the piezoelectric transducer were tested. The result showed that stapes displacement stimulated by the transducer excitation at 10.5 V RMS was equivalent to that from acoustic stimulation at 100 dB SPL, which is an adequate stimulation to the ossicular chain. The corresponding power consumption is 0.31 mW per volt of excitation at 1 kHz, which is low enough for the transducer to be used in a middle ear implant. Besides, this transducer demonstrates high performance at high frequencies. PMID:25045723

  1. Surgical and Technical Modalities for Hearing Restoration in Ear Malformations.

    PubMed

    Dazert, Stefan; Thomas, Jan Peter; Volkenstein, Stefan

    2015-12-01

    Malformations of the external and middle ear often go along with an aesthetic and functional handicap. Independent of additional aesthetic procedures, a successful functional hearing restoration leads to a tremendous gain in quality of life for affected patients. The introduction of implantable hearing systems (bone conduction and middle ear devices) offers new therapeutic options in this field. We focus on functional rehabilitation of patients with malformations, either by surgical reconstruction or the use of different implantable hearing devices, depending on the disease itself and the severity of malformation as well as hearing impairment. Patients with an open ear canal and minor malformations are good candidates for surgical hearing restoration of middle ear structures with passive titanium or autologous implants. In cases with complete fibrous or bony atresia of the ear canal, the most promising functional outcome and gain in quality of life can be expected with an active middle ear implant or a bone conduction device combined with a surgical aesthetic rehabilitation in a single or multi-step procedure. Although the surgical procedure for bone conduction devices is straightforward and safe, more sophisticated operations for active middle ear implants (e.g., Vibrant Soundbridge, MED-EL, Innsbruck, Austria) provide an improved speech discrimination in noise and the ability of sound localization compared with bone conduction devices where the stimulation reaches both cochleae.

  2. Accumulation of Regulatory T Cells and Chronic Inflammation in the Middle Ear in a Mouse Model of Chronic Otitis Media with Effusion Induced by Combined Eustachian Tube Blockage and Nontypeable Haemophilus influenzae Infection.

    PubMed

    Hirano, Takashi; Kodama, Satoru; Kawano, Toshiaki; Suzuki, Masashi

    2015-11-09

    Nontypeable Haemophilus influenzae (NTHi) is associated with chronic otitis media (COM). In this study, we generated a murine model of COM by using eustachian tube (ET) obstruction and NTHi (10(7) CFU) inoculation into the tympanic bulla, and we investigated the relationship between regulatory T cells (Treg) and chronic inflammation in the middle ear. Middle ear effusions (MEEs) and middle ear mucosae (MEM) were collected at days 3 and 14 and at 1 and 2 months after inoculation. Untreated mice served as controls. MEEs were used for bacterial counts and to measure the concentrations of cytokines. MEM were collected for histological evaluation and flow cytometric analysis. Inflammation of the MEM was prolonged throughout this study, and the incidence of NTHi culture-positive MEE was 38% at 2 months after inoculation. The levels of interleukin-1β (IL-β), tumor necrosis factor alpha, IL-10, and transforming growth factor β were increased in the middle ear for up to 2 months after inoculation. CD4(+) CD25(+) FoxP3(+) Treg accumulated in the middle ear, and the percentage of Treg in the MEM increased for up to 2 months after inoculation. Treg depletion induced a 99.9% reduction of bacterial counts in MEEs and also significantly reduced the ratio of NTHi culture-positive MEE. The levels of these cytokines were also reduced in MEEs. In summary, we developed a murine model of COM, and our findings indicate that Treg confer infectious tolerance to NTHi in the middle ear.

  3. Accumulation of Regulatory T Cells and Chronic Inflammation in the Middle Ear in a Mouse Model of Chronic Otitis Media with Effusion Induced by Combined Eustachian Tube Blockage and Nontypeable Haemophilus influenzae Infection

    PubMed Central

    Kodama, Satoru; Kawano, Toshiaki

    2015-01-01

    Nontypeable Haemophilus influenzae (NTHi) is associated with chronic otitis media (COM). In this study, we generated a murine model of COM by using eustachian tube (ET) obstruction and NTHi (107 CFU) inoculation into the tympanic bulla, and we investigated the relationship between regulatory T cells (Treg) and chronic inflammation in the middle ear. Middle ear effusions (MEEs) and middle ear mucosae (MEM) were collected at days 3 and 14 and at 1 and 2 months after inoculation. Untreated mice served as controls. MEEs were used for bacterial counts and to measure the concentrations of cytokines. MEM were collected for histological evaluation and flow cytometric analysis. Inflammation of the MEM was prolonged throughout this study, and the incidence of NTHi culture-positive MEE was 38% at 2 months after inoculation. The levels of interleukin-1β (IL-β), tumor necrosis factor alpha, IL-10, and transforming growth factor β were increased in the middle ear for up to 2 months after inoculation. CD4+ CD25+ FoxP3+ Treg accumulated in the middle ear, and the percentage of Treg in the MEM increased for up to 2 months after inoculation. Treg depletion induced a 99.9% reduction of bacterial counts in MEEs and also significantly reduced the ratio of NTHi culture-positive MEE. The levels of these cytokines were also reduced in MEEs. In summary, we developed a murine model of COM, and our findings indicate that Treg confer infectious tolerance to NTHi in the middle ear. PMID:26553466

  4. Postoperative Intensity-Modulated Radiotherapy for Squamous Cell Carcinoma of the External Auditory Canal and Middle Ear: Treatment Outcomes, Marginal Misses, and Perspective on Target Delineation

    SciTech Connect

    Chen, Wan-Yu; Kuo, Sung-Hsin; Chen, Yu-Hsuan; Lu, Szu-Huai; Tsai, Chiao-Ling; Chia-Hsien Cheng, Jason; Hong, Ruey-Long; Chen, Ya-Fang; Hsu, Chuan-Jen; Lin, Kai-Nan; Ko, Jenq-Yuh; Lou, Pei-Jen; Wang, Cheng-Ping; Chong, Fok-Ching; Wang, Chun-Wei

    2012-03-15

    Purpose: To report outcomes of the rare disease of squamous cell carcinoma (SCC) of the external auditory canal (EAC) and middle ear treated with surgery and postoperative intensity-modulated radiotherapy (IMRT). Failure patterns related to spatial dose distribution were also analyzed to provide insight into target delineation. Methods and Materials: A retrospective review was conducted of the records of 11 consecutive patients with SCC of the EAC and middle ear who were treated with curative surgery and postoperative IMRT at one institution between January 2007 and February 2010. The prescribed IMRT dose was 60 to 66 Gy at 2 Gy per fraction. Three patients also received concurrent cisplatin-based chemotherapy, and 1 patient received concurrent oral tegafur/uracil. The median follow-up time was 19 months (range, 6-33 months). Results: Four patients had locoregional recurrence, yielding an estimated 2-year locoregional control rate of 70.7%. Among them, 1 patient had persistent disease after treatment, and 3 had marginal recurrence. Distant metastasis occurred in 1 patient after extensive locoregional recurrence, yielding an estimated 2-year distant control rate of 85.7%. The estimated 2-year overall survival was 67.5%. The three cases of marginal recurrence were near the preauricular space and glenoid fossa of the temporomandibular joint, adjacent to the apex of the ear canal and glenoid fossa of the temporomandibular joint, and in the postauricular subcutaneous area and ipsilateral parotid nodes, respectively. Conclusions: Marginal misses should be recognized to improve target delineation. When treating SCC of the EAC and middle ear, care should be taken to cover the glenoid fossa of the temporomandibular joint and periauricular soft tissue. Elective ipsilateral parotid irradiation should be considered. The treatment planning procedure should also be refined to balance subcutaneous soft-tissue dosimetry and toxicity.

  5. Influence of Pneumococcal Conjugate Vaccine on Acute Otitis Media with Severe Middle Ear Inflammation: A Retrospective Multicenter Study

    PubMed Central

    Sugino, Hirotoshi; Tsumura, Shigeru; Kunimoto, Masaru; Noda, Masuhiro; Chikuie, Daisuke; Noda, Chieko; Yamashita, Mariko; Watanabe, Hiroshi; Ishii, Hidemasa; Tashiro, Toru; Iwata, Kazuhiro; Kono, Takashi; Tsumura, Kaoru; Sumiya, Takahiro; Takeno, Sachio; Hirakawa, Katsuhiro

    2015-01-01

    The Japanese guidelines for acute otitis media in children recommend classifying acute otitis media by age, manifestations and local findings, and also recommend myringotomy for moderate-grade cases with severe local findings, severe-grade cases, and treatment-resistant cases. The heptavalent pneumococcal conjugate vaccine was released in Japan in February 2010. In Hiroshima City, public funding allowing free inoculation with this vaccine was initiated from January 2011, and the number of vaccinated individuals has since increased dramatically. This study investigated changes in the number of myringotomies performed to treat acute otitis media during the 5-year period from January 2008 to December 2012 at two hospitals and five clinics in the Asa Area of Hiroshima City, Japan. A total of 3,165 myringotomies for acute otitis media were performed. The rate of procedures per child-year performed in <5-year-old children decreased by 29.1% in 2011 and by 25.2% in 2012 compared to the mean rate performed in the 3 years prior to the introduction of public funding. A total of 895 myringotomies were performed for 1-year-old infants. The rate of myringotomies per child-year performed for acute otitis media in 1-year-old infants decreased significantly in the 2 years after the introduction of public funding for heptavalent pneumococcal conjugate vaccine compared to all years before introduction (p<0.000001). Our results suggest a benefit of heptavalent pneumococcal conjugate vaccine for acute otitis media in reducing the financial burden of myringotomy. In addition, this vaccine may help prevent acute otitis media with severe middle ear inflammation in 1-year-old infants. PMID:26348230

  6. Primary investigations on the potential of a novel diode pumped Er:YAG laser system for middle ear surgery

    NASA Astrophysics Data System (ADS)

    Stock, Karl; Wurm, Holger; Hausladen, Florian

    2016-02-01

    Flashlamp pumped Er:YAG lasers are successfully used clinically for both precise soft and hard tissue ablation. Since several years a novel diode pumped Er:YAG laser system (Pantec Engineering AG) is available, with mean laser power up to 40 W and pulse repetition rate up to 1 kHz. The aim of the study was to investigate the suitability of the laser system specifically for stapedotomy. Firstly an experimental setup was realized with a beam focusing unit and a computer controlled translation stage to move the samples (slices of porcine bone) with a defined velocity while irradiation with various laser parameters. A microphone was positioned in a defined distance to the ablation point and the resulting acoustic signal of the ablation process was recorded. For comparison, measurements were also performed with a flash lamp pumped Er:YAG laser system. After irradiation the resulting ablation quality and efficacy were determined using light microscopy. Using a high speed camera and "Töpler-Schlierentechnik" the cavitation bubble in water after perforation of a bone slice was investigated. The results show efficient bone ablation using the diode pumped Er:YAG laser system. Also a decrease of the sound level and of the cavitation bubble volume was observed with decreasing pulse duration. Higher repetition rates lead to a slightly increase of thermal side effects but have no influence on the ablation efficiency. In conclusion, these first experiments demonstrate the high potential of the diode pumped Er:YAG laser system for use in middle ear surgery.

  7. Influence of Pneumococcal Conjugate Vaccine on Acute Otitis Media with Severe Middle Ear Inflammation: A Retrospective Multicenter Study.

    PubMed

    Sugino, Hirotoshi; Tsumura, Shigeru; Kunimoto, Masaru; Noda, Masuhiro; Chikuie, Daisuke; Noda, Chieko; Yamashita, Mariko; Watanabe, Hiroshi; Ishii, Hidemasa; Tashiro, Toru; Iwata, Kazuhiro; Kono, Takashi; Tsumura, Kaoru; Sumiya, Takahiro; Takeno, Sachio; Hirakawa, Katsuhiro

    2015-01-01

    The Japanese guidelines for acute otitis media in children recommend classifying acute otitis media by age, manifestations and local findings, and also recommend myringotomy for moderate-grade cases with severe local findings, severe-grade cases, and treatment-resistant cases. The heptavalent pneumococcal conjugate vaccine was released in Japan in February 2010. In Hiroshima City, public funding allowing free inoculation with this vaccine was initiated from January 2011, and the number of vaccinated individuals has since increased dramatically. This study investigated changes in the number of myringotomies performed to treat acute otitis media during the 5-year period from January 2008 to December 2012 at two hospitals and five clinics in the Asa Area of Hiroshima City, Japan. A total of 3,165 myringotomies for acute otitis media were performed. The rate of procedures per child-year performed in <5-year-old children decreased by 29.1% in 2011 and by 25.2% in 2012 compared to the mean rate performed in the 3 years prior to the introduction of public funding. A total of 895 myringotomies were performed for 1-year-old infants. The rate of myringotomies per child-year performed for acute otitis media in 1-year-old infants decreased significantly in the 2 years after the introduction of public funding for heptavalent pneumococcal conjugate vaccine compared to all years before introduction (p<0.000001). Our results suggest a benefit of heptavalent pneumococcal conjugate vaccine for acute otitis media in reducing the financial burden of myringotomy. In addition, this vaccine may help prevent acute otitis media with severe middle ear inflammation in 1-year-old infants.

  8. Cartilage graft or fascia in tympanoplasty in patients with low middle ear risk index (anatomical and audological results).

    PubMed

    Callioglu, Elif Ersoy; Ceylan, B Tijen; Kuran, Gokhan; Demirci, Sule; Tulaci, Kamil Gokce; Caylan, Refik

    2013-11-01

    The aim of this study was to compare anatomic and audiological results of cartilage graft with temporal fascia graft in type 1 tympanoplasty patients with low middle ear risk index (MERI). In this retrospective study, 63 patients that underwent type 1 tympanoplasty with chondroperichondrial island graft between July 2009 and November 2010 were compared with 45 patients in whom temporal muscle fascia was used. Patients in both groups had low MERI values varying between 1 and 3. Five and nine patients underwent masteidectomy in cartilage and fascia group, respectively. Mean duration of follow-up was 11.9 ± 3.7 (5-17) months. Mean value was calculated at pre-operative and post-operative hearing threshold 0.5, 1, 2, 4 kHz, and air bone gap (ABG) gain was compared in both cartilage and fascia groups. when pre-operative and post-operative ABG gain were compared, significant decrease was seen in ABG levels (p < 0.001). However, no significant difference was seen in ABG gain values (p = 0.608), which was 10.1 ± 7.00 dB in cartilage group and 10.8 ± 5.38 dB in fascia group. In both groups, age, sex, and the addition of mastoidectomy procedure had no significant effect on ABG gain and success. Cartilage is a graft material that may be preferred without concern about the effects on hearing results, especially, in patients with low MERI values. The addition of mastoidectomy had no impact on the outcome of operation and audiological results. However, further studies with larger case series may be carried out to further clarify the issue.

  9. Drug delivery to the ear.

    PubMed

    Hoskison, E; Daniel, M; Al-Zahid, S; Shakesheff, K M; Bayston, R; Birchall, J P

    2013-01-01

    Drug delivery to the ear is used to treat conditions of the middle and inner ear such as acute and chronic otitis media, Ménière's disease, sensorineural hearing loss and tinnitus. Drugs used include antibiotics, antifungals, steroids, local anesthetics and neuroprotective agents. A literature review was conducted searching Medline (1966-2012), Embase (1988-2012), the Cochrane Library and Ovid (1966-2012), using search terms 'drug delivery', 'middle ear', 'inner ear' and 'transtympanic'. There are numerous methods of drug delivery to the middle ear, which can be categorized as topical, systemic (intravenous), transtympanic and via the Eustachian tube. Localized treatments to the ear have the advantages of targeted drug delivery allowing higher therapeutic doses and minimizing systemic side effects. The ideal scenario would be a carrier system that could cross the intact tympanic membrane loaded with drugs or biochemical agents for the treatment of middle and inner ear conditions.

  10. Swimmer's Ear

    MedlinePlus

    ... Homework? Here's Help White House Lunch Recipes Swimmer's Ear KidsHealth > For Kids > Swimmer's Ear Print A A ... How Do I Know if I Have Swimmer's Ear? Swimmer's ear may start with some itching, but ...

  11. Ear Tubes

    MedlinePlus

    ... Meeting Calendar Find an ENT Doctor Near You Ear Tubes Ear Tubes Patient Health Information News media ... and throat specialist) may be considered. What are ear tubes? Ear tubes are tiny cylinders placed through ...

  12. Falling on sensitive ears: constraints on bilingual lexical activation.

    PubMed

    Ju, Min; Luce, Paul A

    2004-05-01

    Spoken word recognition is characterized by multiple activation of sound patterns that are consistent with the acoustic-phonetic input. Recently, an extreme form of multiple activation was observed: Bilingual listeners activated words from both languages that were consistent with the input. We explored the degree to which bilingual multiple activation may be constrained by fine-grained acoustic-phonetic information. In a head-mounted eyetracking experiment, we presented Spanish-English bilinguals with spoken Spanish words having word-initial stop consonants with either English- or Spanish-appropriate voice onset times. Participants fixated interlingual distractors (nontarget pictures whose English names shared a phonological similarity with the Spanish targets) more frequently than control distractors when the target words contained English-appropriate voice onset times. These results demonstrate that fine-grained acoustic-phonetic information and a precise match between input and representation are critical for parallel activation of two languages.

  13. Ear Infections and Language Development.

    ERIC Educational Resources Information Center

    Roberts, Joanne E.; Zeisel, Susan A.

    Ear infections in infants and preschoolers can cause mild or moderate temporary hearing loss, which may in turn affect a child's ability to understand and learn language. Noting that providing children with proper medical treatment for ear infections or middle ear fluid is important in preventing possible problems with language development, this…

  14. [Evolution of the ear].

    PubMed

    Qvist, Morten Rosenkilde

    2009-12-14

    The evolution of the ear may be traced through transitional fossils, comparative anatomy and embryology. The organ of hearing evolved from receptors of the vestibulary organ of fish. The tympanic ear developed in amphibians at the transition to terrestrial life, and the hyomandibula was isolated as the first middle ear bone, the columella stapes. Reptile jaw bones, quadratum and articulare, transformed to malleus and incus in mammals. With selective advantages during the evolution, an increasing structural complexity of the ear accompanied improved sound transmission and reception.

  15. Use of the nine-step inflation/deflation test as a predictor of middle ear barotrauma in sports scuba divers.

    PubMed

    Uzun, C; Adali, M K; Tas, A; Koten, M; Karasalihoglu, A R; Devren, M

    2000-06-01

    Middle ear (ME) barotrauma, the most common disorder encountered in diving, results from inadequate pressure equilibration between the ME and the ambient environment. Eustachian tube function plays a key role in the pathogenesis of barotrauma. This study was designed to investigate the predictive value and efficiency of tympanometric tests of Eustachian tube function (Valsalva test, Toynbee test and nine-step inflation/deflation test) in predicting ME barotrauma in 44 ears of 22 sports scuba divers who had normal audiometry, tympanometry and otorhinolaryngological examination without previous history of ear disease. The divers were counselled to refer to the investigators if any symptoms occurred during and/or after diving. All symptomatic ears were examined within 24 hours of diving by one investigator who was unaware of the pre-symptomatic test results. Decision matrix analysis was applied to the results of Eustachian tube function tests for predicting ears with barotrauma. Values were also evaluated for a battery of tests by 'Lax' (positive on A, B or C) and 'Strict' (positive on A, B and C) criteria. The nine-step test was found to be the most efficient (93%) test with highest predictive values (PPV 83%; NPV 95%), whereas the Valsalva and Toynbee tests were unreliable in predicting barotrauma, whereas the Valsalva and Toynbee tests were unreliable in predicting barotrauma (PPV of the Valsalva and Toynbee tests were 0% and 25% respectively). Combining the nine-step and Toynbee tests into a two-test battery in a strict approach increased the PPV (100%). It appears that the nine-step inflation/deflation test is a reliable method of predicting ME barotrauma sufferers, especially when applied with the Toynbee test. The nine-step test may have value in the evaluation of Eustachian tube function of sports scuba diving candidates after routine otorhinolaryngological, audiological and tympanometric evaluation.

  16. In vitro antimicrobial activity of orbifloxacin against Staphylococcus intermedius isolates from canine skin and ear infections.

    PubMed

    Ganière, Jean-Pierre; Médaille, Christine; Etoré, Florence

    2004-08-01

    The objective of the study was to evaluate the in vitro activity of orbifloxacin against Staphylococcus intermedius strains isolated in France from canine skin and ear infections. The minimum inhibitory concentrations (MICs) of orbifloxacin against 240 field S. intermedius isolates (69 skin and 171 ear isolates) ranged from 0.016 to 8 mg l(-1), with MIC50 and MIC90 equal to 0.5 and 1 mg l(-1), respectively. Only one strain, a pyoderma isolate was resistant (MIC=8 mg l(-1)). Orbifloxacin was tested at different concentrations for killing rate against five isolates obtained from pyoderma cases and against a reference strain (Staphylococcus aureus ATCC 29213). Orbifloxacin expressed a concentration-dependent bactericidal activity against the S. aureus reference strain, but a time-dependent bactericidal activity against S. intermedius. Orbifloxacin induced bactericidal effect against the S. intermedius strains tested with concentrations equal to or two times MIC.

  17. Effect of intravenous clonidine premedication for the bloodless surgical field in patients undergoing middle ear or nasal surgery: A comparison of three different doses

    PubMed Central

    Ramchandani, Sarita; Lakra, Anand Masih; Shah, Pratibha Jain; Lalwani, Jaya; Sahare, Kamal Kishore

    2015-01-01

    Aim: To evaluate the effect of intravenous (IV) clonidine premedication for the bloodless surgical field in patients undergoing middle ear or nasal surgery comparing three different doses. Subjects and Methods: This prospective randomized, clinical trial was performed on 90 normotensive patients belonging to American Society of Anesthesiologists grade I/II, aged 18–60 years, of either sex, undergoing routine middle ear or nasal surgery. These patients were divided into three Groups A, B, and C with 30 patients in each according to the dose of IV clonidine used as premedicant that is 3, 4, and 5 µg/kg, respectively. The hypotensive period commenced 10 min after the start of surgery till the surgeon's request for no hypotension required any longer. The target mean blood pressure for producing bloodless surgical field was 60–70 mmHg. During the hypotensive period, the surgeons were asked to rate the bleeding severity score on a six-point scale from 0 (no bleeding) to 5 (severe bleeding). Statistical Analysis Used: ANOVA, Chi-square test, Z-test, standard deviation and P value. Results: IV clonidine premedication in a dose of 4 and 5 µg/kg reduces bleeding and provides a clear field for surgery. It also reduces the requirement of isoflurane, fentanyl, and metoprolol for controlled hypotension. However, clonidine 5 µg/kg was not more effective than clonidine 4 µg/kg in producing these effects rather was associated with some side effects. Conclusion: IV clonidine premedication in a dose of 4 µg/kg is safe and effective for producing a bloodless surgical field in the middle ear and nasal surgery. PMID:26712981

  18. A Tympanal Insect Ear Exploits a Critical Oscillator for Active Amplification and Tuning

    PubMed Central

    Mhatre, Natasha; Robert, Daniel

    2013-01-01

    Summary A dominant theme of acoustic communication is the partitioning of acoustic space into exclusive, species-specific niches to enable efficient information transfer. In insects, acoustic niche partitioning is achieved through auditory frequency filtering, brought about by the mechanical properties of their ears [1]. The tuning of the antennal ears of mosquitoes [2] and flies [3], however, arises from active amplification, a process similar to that at work in the mammalian cochlea [4]. Yet, the presence of active amplification in the other type of insect ears—tympanal ears—has remained uncertain [5]. Here we demonstrate the presence of active amplification and adaptive tuning in the tympanal ear of a phylogenetically basal insect, a tree cricket. We also show that the tree cricket exploits critical oscillator-like mechanics, enabling high auditory sensitivity and tuning to conspecific songs. These findings imply that sophisticated auditory mechanisms may have appeared even earlier in the evolution of hearing and acoustic communication than currently appreciated. Our findings also raise the possibility that frequency discrimination and directional hearing in tympanal systems may rely on physiological nonlinearities, in addition to mechanical properties, effectively lifting some of the physical constraints placed on insects by their small size [6] and prompting an extensive reexamination of invertebrate audition. PMID:24076240

  19. Swimmer's ear

    MedlinePlus

    ... such as acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) Vinegar (acetic acid) ear drops People with chronic swimmer's ear may ... drop of alcohol with 1 drop of white vinegar and placing the mixture into the ears after ...

  20. Cauliflower Ear

    MedlinePlus

    ... Here's Help White House Lunch Recipes What's Cauliflower Ear? KidsHealth > For Kids > What's Cauliflower Ear? Print A A A Text Size Have you ever seen someone whose ear looks bumpy and lumpy? The person might have ...

  1. An immunohistochemical study of the middle ear muscles of some carnivores and primates, with special reference to the IIM and slow-tonic fibre types.

    PubMed Central

    Mascarello, F; Veggetti, A; Cerpenè, E; Rowlerson, A

    1983-01-01

    The middle ear muscles of several species of carnivores (cat, dog, fox, ferret and stone-marten) and some New World monkeys (Callithrix, Saimiri) and Old World monkeys (Cercopithecus, Macaca) were examined. The fibre type compositions of these muscles were determined by a combination of the standard histochemical myofibrillar ATPase method, and immunohistochemical techniques using myosintype-specific antisera. Immunohistochemically slow-tonic fibres were found in the stapedius muscles of only two carnivores, the ferret and stone-marten. In all the carnivores and the New World monkeys, tensor tympani muscle contained IIM, slow-tonic and slow-twitch fibres, but in the Old World monkeys it resembled stapedius muscle, and contained only Type I (slow-twitch) and IIA fibres. Thus, because all the species examined had IIM fibres in the jaw-closer muscles, this means that the common embryological origin of tensor tympani muscle and the jaw-closers does not necessarily result in tensor tympani muscle containing this fibre type even though IIM fibres occur only in first branchial arch muscles. This fact, together with other species differences in the fibre type composition of these muscles, shows that there is no typical composition of middle ear muscles in general, and suggests that the differences are related to very different functional requirements. Images Fig. 1 Fig. 2 Fig. 3 Fig. 4 Fig. 5 Fig. 6 Fig. 7 PMID:6415024

  2. Selective adherence of non-typeable Haemophilus influenzae (NTHi) to mucus or epithelial cells in the chinchilla eustachian tube and middle ear.

    PubMed

    Miyamoto, N; Bakaletz, L O

    1996-11-01

    Frozen sections of chinchilla Eustachian tube (ET) and middle ear mucosa were incubated with either FITC-labeled non-typeable Haemophilus influenzae (NTHi) or Bordetella pertussis. The number of bacteria adherent to "roof" vs "floor" regions was compared for each of three anatomic portions of the ET and for middle ear epithelium noting whether bacteria adhered to mucus or to epithelial cells. NTHi strains adhered significantly greater to mucus in the ET lumen whereas B. pertussis preferentially adhered to epithelial cells lining the ET (P < or = 0.05). A non-fimbriated isogenic mutant of NTHi adhered significantly less to mucus than the parental isolate at all sites of the ET floor (P < or = 0.05). Isolated fimbrin protein adhered to ET mucus and blocked adherence of whole organisms. Treatment with the mucolytic agent N-acetyl-L-cysteine resulted in significantly reduced adherence of NTHi to mucus (P < or = 0.001) and eliminated the ability to detect binding of isolated fimbrin protein. N-acetyl-L-cysteine treatment did not affect adherence of either B. pertussis or NTHi to epithelial cells. These data indicated that NTHi may mediate ascension of the ET from the nasopharynx primarily via adherence to and growth in mucus overlying the floor region of the tubal lumen. The OMP P5-homologous fimbriae were shown to contribute to this binding.

  3. Ear canal cholesteatoma.

    PubMed

    Holt, J J

    1992-06-01

    Although cholesteatomas are more commonly found in the middle ear and the mastoid, the disease can occur in the external ear canal. All cases of ear canal cholesteatoma treated by the author were reviewed. There were nine ears in seven patients, who had an average age of 62 years. The lesions ranged in size from a few millimeters to extensive mastoid destruction. Smaller lesions can be managed by frequent cleaning as an office procedure. Larger lesions require surgery, either canaloplasty or mastoidectomy. The otolaryngologist should suspect this disease in the elderly. Microscopic examination of the ear with meticulous cleaning of all wax, especially in elderly patients, is most useful in detecting early disease. Frequent applications of mineral oil to the canal should be used in the management of the disease and to prevent recurrence.

  4. Ear Pieces

    ERIC Educational Resources Information Center

    DiJulio, Betsy

    2011-01-01

    In this article, the author describes an art project wherein students make fanciful connections between art and medicine. This project challenges students to interpret "ear idioms" (e.g. "blow it out your ear," "in one ear and out the other") by relying almost entirely on realistic ear drawings, the placement of them, marks, and values. In that…

  5. Ear trauma.

    PubMed

    Eagles, Kylee; Fralich, Laura; Stevenson, J Herbert

    2013-04-01

    Understanding basic ear anatomy and function allows an examiner to quickly and accurately identify at-risk structures in patients with head and ear trauma. External ear trauma (ie, hematoma or laceration) should be promptly treated with appropriate injury-specific techniques. Tympanic membrane injuries have multiple mechanisms and can often be conservatively treated. Temporal bone fractures are a common cause of ear trauma and can be life threatening. Facial nerve injuries and hearing loss can occur in ear trauma.

  6. Alteration of gene expression in human middle ear epithelial cells induced by influenza A virus and its implication for the pathogenesis of otitis media.

    PubMed

    Tong, Hua Hua; Long, James P; Li, Daneng; DeMaria, Thomas F

    2004-10-01

    Influenza A virus infection plays a significant role in the pathogenesis of Streptococcus pneumoniae-induced acute otitis media in children. An understanding of how influenza A virus modulates host cellular responses is critically important in efforts to explore the molecular mechanisms of this synergism. We used microarray technology to characterize the mRNA expression profile in human middle ear epithelial cells induced by influenza A virus. Alterations of mRNA expression in 142 out of approximately 12,600 genes were observed at 24h after virus infection. Of these 142 genes with altered expression, interferon inducible genes, chemokine and cytokine genes, pro- and antiapoptotic genes, signal transduction and transcription factors, cellular immune response, cell cycle and metabolism genes were the most prominent. Our results reveal several previously unknown alterations of host gene expression induced by influenza A virus which may provide new targets for further analysis of its role in this particular host-pathogen interaction.

  7. Growth Hormone Treatment Does Not Affect Incidences of Middle Ear Disease or Hearing Loss in Infants and Toddlers with Turner Syndrome

    PubMed Central

    Davenport, Marsha L.; Roush, Jackson; Liu, Chunhua; Zagar, Anthony J.; Eugster, Erica; Travers, Sharon; Fechner, Patricia Y.; Quigley, Charmian A.

    2010-01-01

    Context No randomized, controlled, prospective study has evaluated the effect of growth hormone (GH) on the rates of middle ear (ME) disease and hearing loss in girls with Turner syndrome (TS). Design A 2-year, prospective, randomized, controlled, open-label, multicenter, clinical trial (‘Toddler Turner Study’; August 1999 to August 2003) was carried out. Setting The study was conducted at 11 US pediatric endocrine centers. Subjects Eighty-eight girls with TS, aged 9 months to 4 years, were enrolled. Intervention The interventions comprised recombinant GH (50 μg/kg/day, n = 45) or no treatment (n = 43) for 2 years. Main Outcome Measures The outcome measures included occurrence rates of ear-related problems, otitis media (OM) and associated antibiotic treatments, tympanometric assessment of ME function and hearing assessment by audiology. Results At baseline, 57% of the girls (mean age = 1.98 ± 1.00 years) had a history of recurrent OM, 33% had undergone tympanostomy tube (t-tube) insertion and 27% had abnormal hearing. There was no significant difference between the treatment groups for annual incidence of OM episodes (untreated control: 1.9 ± 1.4; GH-treated: 1.5 ± 1.6, p = 0.17). A quarter of the subjects underwent ear surgeries (mainly t-tube insertions) during the study. Recurrent or persistent abnormality of ME function on tympanometry was present in 28–45% of the girls without t-tubes at the 6 postbaseline visits. Hearing deficits were found in 19–32% of the girls at the annual postbaseline visits. Most of these were conductive deficits, however, 2 girls had findings consistent with sensorineural hearing loss, which was evident before 3 years of age. Conclusions Ear and hearing problems are common in infants and toddlers with TS and are not significantly influenced by GH treatment. Girls with TS need early, regular and thorough ME monitoring by their primary care provider and/or otolaryngologist, and at least annual hearing evaluations by a

  8. Your Ears

    MedlinePlus

    ... Protect your hearing by wearing earplugs at loud music concerts and around noisy machinery, like in wood ... For Parents MORE ON THIS TOPIC Can Loud Music Hurt My Ears? What Is an Ear Infection? ...

  9. Ear wax

    MedlinePlus

    The ear canal is lined with hair follicles and glands that produce a waxy oil called cerumen. The wax will most ... Wax can build up and block the ear canal. Wax blockage is one of the most common ...

  10. Activity Preferences of Middle School Physical Education Students.

    ERIC Educational Resources Information Center

    Greenwood, Michael; Stillwell, Jim; Byars, Allyn

    2001-01-01

    Investigated the physical education activity preferences of middle school students who completed a checklist featuring a variety of activities. Overall, middle school boys and girls both differed and agreed on their interests for specific activities. Most students liked basketball, bicycling, roller skating, soccer, swimming, and volleyball but…

  11. Listening to the Ear

    NASA Astrophysics Data System (ADS)

    Shera, Christopher Alan

    Otoacoustic emissions demonstrate that the ear creates sound while listening to sound, offering a promising acoustic window on the mechanics of hearing in awake, listening human beings. That window is clouded, however, by an incomplete knowledge of wave reflection and transmission, both forth and back within the cochlea and through the middle ear. This thesis "does windows," addressing wave propagation and scattering on both sides of the middle ear. A summary of highlights follows. Measurements of the cochlear input impedance in cat are used to identify a new symmetry in cochlear mechanics--termed "tapering symmetry" after its geometric interpretation in simple models--that guarantees that the wavelength of the traveling wave changes slowly with position near the stapes. Waves therefore propagate without reflection through the basal turns of the cochlea. Analytic methods for solving the cochlear wave equations using a perturbative scattering series are given and used to demonstrate that, contrary to common belief, conventional cochlear models exhibit negligible internal reflection whether or not they accurately represent the tapering symmetries of the inner ear. Frameworks for the systematic "deconstruction" of eardrum and middle-ear transduction characteristics are developed and applied to the analysis of noninvasive measurements of middle-ear and cochlear mechanics. A simple phenomenological model of inner-ear compressibility that correctly predicts hearing thresholds in patients with missing or disarticulated middle-ear ossicles is developed and used to establish an upper bound on cochlear compressibility several orders of magnitude smaller than that provided by direct measurements. Accurate measurements of stimulus -frequency evoked otoacoustic emissions are performed and used to determine the form and frequency variation of the cochlear traveling-wave ratio noninvasively. Those measurements are inverted to obtain the spatial distribution of mechanical

  12. Listening to the ear

    NASA Astrophysics Data System (ADS)

    Shera, Christopher A.

    Otoacoustic emissions demonstrate that the ear creates sound while listening to sound, offering a promising acoustic window on the mechanics of hearing in awake, listening human beings. That window is clouded, however, by an incomplete knowledge of wave reflection and transmission, both forth and back within the cochlea and through the middle ear. This thesis "does windows," addressing wave propagation and scattering on both sides of the middle ear. A summary of highlights follows. Measurements of the cochlear input impedance in cat are used to identify a new symmetry in cochlear mechanics-termed "tapering symmetry" after its geometric interpretation in simple models-that guarantees that the wavelength of the traveling wave changes slowly with position near the stapes. Waves therefore propagate without reflection through the basal turns of the cochlea. Analytic methods for solving the cochlear wave equations using a perturbative scattering series are given and used to demonstrate that, contrary to common belief, conventional cochlear models exhibit negligible internal reflection whether or not they accurately represent the tapering symmetries of the inner ear. Frameworks for the systematic "deconstruction" of eardrum and middle-ear transduction characteristics are developed and applied to the analysis of noninvasive measurements of middle-ear and cochlear mechanics. A simple phenomenological model of inner-ear compressibility that correctly predicts hearing thresholds in patients with missing or disarticulated middle-ear ossicles is developed and used to establish an upper bound on cochlear compressibility several orders of magnitude smaller than that provided by direct measurements. Accurate measurements of stimulus frequency evoked otoacoustic emissions are performed and used to determine the form and frequency variation of the cochlear traveling-wave ratio noninvasively. Those measurements are inverted to obtain the spatial distribution of mechanical

  13. An Application of Outer Membrane Protein P6-Specific Enzyme-Linked Immunosorbent Assay for Detection of Haemophilus influenzae in Middle Ear Fluids and Nasopharyngeal Secretions

    PubMed Central

    Hotomi, Muneki; Togawa, Akihisa; Kono, Masamitsu; Sugita, Gen; Sugita, Rinya; Fujimaki, Yutaka; Kamide, Yosuke; Uchizono, Akihiro; Kanesada, Keiko; Sawada, Shoichi; Okitsu, Naohiro; Masuda, Hisayo; Tanaka, Hideaki; Tanaka, Yumi; Yamanaka, Noboru

    2013-01-01

    An enzyme-linked immunosorbent assay specific to outer membrane protein P6 (P6-ELISA) was applied for detecting Haemophilus influenzae in middle ear fluids (MEFs) from acute otitis media (AOM) patients and in nasopharyngeal secretions (NPSs) from acute rhinosinusitis patients. P6-ELISA had a sensitivity of 83.3% for MEFs and 71.5% for NPSs and a specificity of 85.6% for MEFs and 92.5% for NPSs, respectively. Real-time PCR exhibited significant differences in the number of ompP1 gene copies among samples determined by P6-ELISA to be positive and negative for H. influenzae. However, because the P6-ELISA test has the reactivity in Haemophilus species include two commensals H. haemolyticus and H. parainfluenzae, it is thus a weak method in order to detect only NTHi correctly. Consequently, diagnosis using the P6-ELISA should be based on an overall evaluation, including the results of other related examinations and clinical symptoms to prevent misleading conclusions in clinical setting. PMID:24015192

  14. Detection of respiratory pathogens in pediatric acute otitis media by PCR and comparison of findings in the middle ear and nasopharynx.

    PubMed

    Yatsyshina, Svetlana; Mayanskiy, Nikolay; Shipulina, Olga; Kulichenko, Tatiana; Alyabieva, Natalia; Katosova, Lyubovj; Lazareva, Anna; Skachkova, Tatyana; Elkina, Maria; Matosova, Svetlana; Shipulin, German

    2016-05-01

    We conducted a series of polymerase chain reactions (PCRs) in order to detect bacteria (7 species) and viruses (17 species) in middle ear fluid (MEF) and nasopharynx (Nph) of children with acute otitis media (AOM; n=179). Bacterial and viral nucleic acids were detected in MEF of 78.8% and 14.5% patients, respectively. The prevalence was as follows: Streptococcus pneumoniae, 70.4%; Haemophilus influenzae, 17.9%; Staphylococcus aureus, 16.8%; Streptococcus pyogenes, 12.3%; Moraxella catarrhalis, 9.5%; rhinovirus, 9.5%; and adenovirus, 3.4%. The overall rate of PCR-positive specimens for bacterial pathogens was 2.6 times higher, compared to culture results. The rate of PCR-positive results and the distribution of pathogens in the Nph were similar to those in the MEF. Nph PCR results had variable positive predictive values and high negative predictive values in predicting MEF findings. Our results indicate that Nph PCR could be a practical tool for examining respiratory pathogens in children with acute infections.

  15. Ear problems and injuries in athletes.

    PubMed

    Cassaday, Kacie; Vazquez, Gerardo; Wright, Justin M

    2014-01-01

    The ear is an unique organ--the principal structure involved in both hearing and balance. Although not common, problems with the ear may be encountered in specific sporting populations. Common conditions affecting the ear in the athlete include otitis externa, an infection of the external ear; external auditory canal exostoses, or abnormal bony growths in the canal; and otitis media, an infection of the middle ear. Given its position on the head, the ear is subject to trauma, often resulting in an auricular hematoma. Divers, due to pressure changes on descent and ascent, are subject to both ear barotrauma and ear decompression sickness. This article will discuss recognition, treatment, and prevention of these conditions affecting the ear in the athlete.

  16. [Hypopharyngeal carcinoma and red ear drum].

    PubMed

    Bender, B; Widmann, G; Riechelmann, H; Schmutzhard, J

    2011-04-01

    A 46-year-old male patient with an unresectable hypopharyngeal carcinoma was treated with primary radio-chemotherapy. At follow-up, the patient presented with a red ear drum and combined hearing loss. Because of radiotherapy-induced tubal dysfunction, paracentesis was performed. Biopsy of the polypoid middle ear mucosa revealed petrous bone infiltration of hypopharyngeal carcinoma. MRI studies revealed paracarotideal tumor infiltration to the petrous bone and the middle ear arising from a cervical retropharyngeal lymph node metastasis. PMID:20963385

  17. Ear recognition based on Gabor features and KFDA.

    PubMed

    Yuan, Li; Mu, Zhichun

    2014-01-01

    We propose an ear recognition system based on 2D ear images which includes three stages: ear enrollment, feature extraction, and ear recognition. Ear enrollment includes ear detection and ear normalization. The ear detection approach based on improved Adaboost algorithm detects the ear part under complex background using two steps: offline cascaded classifier training and online ear detection. Then Active Shape Model is applied to segment the ear part and normalize all the ear images to the same size. For its eminent characteristics in spatial local feature extraction and orientation selection, Gabor filter based ear feature extraction is presented in this paper. Kernel Fisher Discriminant Analysis (KFDA) is then applied for dimension reduction of the high-dimensional Gabor features. Finally distance based classifier is applied for ear recognition. Experimental results of ear recognition on two datasets (USTB and UND datasets) and the performance of the ear authentication system show the feasibility and effectiveness of the proposed approach.

  18. The effect of an anti-allergic, nasal decongestant combination ('Dimotapp') and sodium cromoglycate nose drops on the histamine content of adenoids, middle ear fluid and nasopharyngeal secretions of children with secretory otitis media.

    PubMed

    Collins, M P; Church, M K

    1983-01-01

    Twenty-four children with secretory otitis media awaiting operation for removal of adenoids were studied to investigate the effects of an antihistamine/nasal decongestant combination ('Dimotapp') and sodium cromoglycate nasal drops on the histamine content of adenoids, middle ear fluid and nasopharyngeal secretions. The children were divided into three age and sex matched groups, one of which acted as a control, and received recommended therapeutic doses of either drug for 7 days immediately prior to operation. The results showed that total adenoid histamine content of both drug groups was significantly raised (p less than 0.05) when compared to the control group. Where present, neither 'Dimotapp' nor sodium cromoglycate had any effect on the mean free histamine in the middle ear fluid. In the sodium cromoglycate group the mean free histamine content of the nasopharyngeal secretions was significantly higher than in the control or 'Dimotapp' groups.

  19. High pneumococcal serotype specific IgG, IgG1 and IgG2 levels in serum and the middle ear of children with recurrent acute otitis media receiving ventilation tubes.

    PubMed

    Corscadden, Karli J; Kirkham, Lea-Ann S; Thornton, Ruth B; Vijayasekaran, Shyan; Coates, Harvey L; Richmond, Peter C; Wiertsema, Selma P

    2013-02-27

    Recurrent acute otitis media (AOM), frequently caused by Streptococcus pneumoniae, is a major paediatric health problem. A reduced antibody response against pneumococcal polysaccharides may contribute to an increased susceptibility to AOM. Using a multiplex bead-based assay we measured IgG, IgG1 and IgG2 levels against 11 pneumococcal polysaccharides in serum samples from 166 children below 3 years of age with a history of at least 3 episodes of acute otitis media receiving ventilation tubes, and 61 healthy controls. Pneumococcal serotype specific IgG was also determined in 144 middle ear effusion samples. Pneumococcal serotype specific IgG, IgG1 and IgG2 levels were similar in children with or without AOM, except for IgG and IgG1 levels against serotype 5, which were significantly higher in children with a history of frequent AOM (IgG: 137.5 μg/ml vs. 84.0 μg/ml; p=0.02; IgG1: 24.5 μg/ml vs. 18.2 μg/ml; p=0.05). The age-related development of pneumococcal serotype-specific IgG, IgG1 and IgG2 levels was similar in children with or without a history of AOM. Pneumococcal serotype specific IgG was present in middle ear effusion and these levels correlated significantly with serum titres. Children with a history of frequent AOM receiving ventilation tubes do not have a deficient IgG, IgG1 or IgG2 response against pneumococcal polysaccharides, either induced by vaccination or due to natural exposure. The strong correlation between IgG levels in serum and the middle ear suggests parenteral pneumococcal conjugate vaccination induces antibodies in the middle ear which may therefore contribute to reducing the burden of AOM.

  20. In vitro antimicrobial activity of a commercial ear antiseptic containing chlorhexidine and Tris-EDTA.

    PubMed

    Guardabassi, Luca; Ghibaudo, Giovanni; Damborg, Peter

    2010-06-01

    Minimum bactericidal concentrations (MBCs) of a commercial ear antiseptic containing chlorhexidine 0.15% and Tris-EDTA (Otodine) were determined by broth microdilution for 150 isolates representing the most common pathogens associated with canine otitis. The microorganisms were classified into three groups according to their levels of susceptibility. The most susceptible group included Staphylococcus pseudintermedius, Malassezia pachydermatis, Streptococcus canis and Corynebacterium auriscanis, which were generally killed by 1 : 64 dilution of the antiseptic product (MBC = 23/0.8 microg/mL of chlorhexidine/Tris-EDTA). The most resistant organism was Proteus mirabilis, which survived up to 1 : 8 dilution of the product (MBC = 375/12 microg/mL). Escherichia coli, Pseudomonas aeruginosa and Staphylococcus aureus displayed intermediate MBCs ranging between 188/6 and 47/1.5 microg/mL. Interestingly, S. pseudintermedius was more susceptible than S. aureus, and no significant difference was observed between meticillin-resistant and meticillin-susceptible isolates within each species, indicating that antiseptic use is unlikely to co-select for meticillin resistance. Although the concentrations required for killing (MBCs) varied considerably with microorganism type, the combination of chlorhexidine 0.15% and Tris-EDTA was active against all the pathogens most commonly involved in canine otitis.

  1. Low-frequency sound affects active micromechanics in the human inner ear

    PubMed Central

    Kugler, Kathrin; Wiegrebe, Lutz; Grothe, Benedikt; Kössl, Manfred; Gürkov, Robert; Krause, Eike; Drexl, Markus

    2014-01-01

    Noise-induced hearing loss is one of the most common auditory pathologies, resulting from overstimulation of the human cochlea, an exquisitely sensitive micromechanical device. At very low frequencies (less than 250 Hz), however, the sensitivity of human hearing, and therefore the perceived loudness is poor. The perceived loudness is mediated by the inner hair cells of the cochlea which are driven very inadequately at low frequencies. To assess the impact of low-frequency (LF) sound, we exploited a by-product of the active amplification of sound outer hair cells (OHCs) perform, so-called spontaneous otoacoustic emissions. These are faint sounds produced by the inner ear that can be used to detect changes of cochlear physiology. We show that a short exposure to perceptually unobtrusive, LF sounds significantly affects OHCs: a 90 s, 80 dB(A) LF sound induced slow, concordant and positively correlated frequency and level oscillations of spontaneous otoacoustic emissions that lasted for about 2 min after LF sound offset. LF sounds, contrary to their unobtrusive perception, strongly stimulate the human cochlea and affect amplification processes in the most sensitive and important frequency range of human hearing. PMID:26064536

  2. In vitro antimicrobial activity of a commercial ear antiseptic containing chlorhexidine and Tris-EDTA.

    PubMed

    Guardabassi, Luca; Ghibaudo, Giovanni; Damborg, Peter

    2010-06-01

    Minimum bactericidal concentrations (MBCs) of a commercial ear antiseptic containing chlorhexidine 0.15% and Tris-EDTA (Otodine) were determined by broth microdilution for 150 isolates representing the most common pathogens associated with canine otitis. The microorganisms were classified into three groups according to their levels of susceptibility. The most susceptible group included Staphylococcus pseudintermedius, Malassezia pachydermatis, Streptococcus canis and Corynebacterium auriscanis, which were generally killed by 1 : 64 dilution of the antiseptic product (MBC = 23/0.8 microg/mL of chlorhexidine/Tris-EDTA). The most resistant organism was Proteus mirabilis, which survived up to 1 : 8 dilution of the product (MBC = 375/12 microg/mL). Escherichia coli, Pseudomonas aeruginosa and Staphylococcus aureus displayed intermediate MBCs ranging between 188/6 and 47/1.5 microg/mL. Interestingly, S. pseudintermedius was more susceptible than S. aureus, and no significant difference was observed between meticillin-resistant and meticillin-susceptible isolates within each species, indicating that antiseptic use is unlikely to co-select for meticillin resistance. Although the concentrations required for killing (MBCs) varied considerably with microorganism type, the combination of chlorhexidine 0.15% and Tris-EDTA was active against all the pathogens most commonly involved in canine otitis. PMID:20030799

  3. Suggested Activities for a Unit on the Middle East.

    ERIC Educational Resources Information Center

    Ediger, Marlow

    1983-01-01

    Student activities that focus on the different cultures and the history of the Middle East from Biblical times to the present are suggested. These include debates, art projects, slide shows, maps, and research problems. (IS)

  4. The overlapping roles of the inner ear and lateral line: the active space of dipole source detection.

    PubMed Central

    Braun, C B; Coombs, S

    2000-01-01

    The problems associated with the detection of sounds and other mechanical disturbances in the aquatic environment differ greatly from those associated with airborne sounds. The differences are primarily due to the incompressibility of water and the corresponding increase in importance of the acoustic near field. The near field, or hydrodynamic field, is characterized by steep spatial gradients in pressure, and detection of the accelerations associated with these gradients is performed by both the inner ear and the lateral line systems of fishes. Acceleration-sensitive otolithic organs are present in all fishes and provide these animals with a form of inertial audition. The detection of pressure gradients, by both the lateral line and inner ear, is the taxonomically most widespread mechanism of sound-source detection amongst vertebrates, and is thus the most likely primitive mode of detecting sound sources. Surprisingly, little is known about the capabilities of either the lateral line or the otolithic endorgan in the detection of vibratory dipole sources. Theoretical considerations for the overlapping roles of the inner ear and lateral line systems in midwater predict that the lateral line will operate over a shorter distance range than the inner ear, although with a much greater spatial resolution. Our empirical results of dipole detection by mottled sculpin, a benthic fish, do not agree with theoretical predictions based on midwater fishes, in that the distance ranges of the two systems appear to be approximately equal. This is almost certainly as a result of physical coupling between the fishes and the substrate. Thus, rather than having a greater active range, the inner ear appears to have a reduced distance range in benthic fishes, and the lateral line distance range may be concomitantly extended. PMID:11079381

  5. Treatment and Prognosis of Squamous Cell Carcinoma of the External Auditory Canal and Middle Ear: A Multi-Institutional Retrospective Review of 87 Patients

    SciTech Connect

    Ogawa, Kazuhiko . E-mail: kogawa@med.u-ryukyu.ac.jp; Nakamura, Katsumasa; Hatano, Kazuo; Uno, Takashi; Fuwa, Nobukazu; Itami, Jun; Kojya, Shizuo; Nakashima, Torahiko; Shinhama, Akihiko; Nakagawa, Takashi; Toita, Takafumi; Sakai, Mitsuhiro; Kodaira, Takeshi; Suzuki, Mikio; Ito, Hisao; Murayama, Sadayuki

    2007-08-01

    Purpose: To examine the relative roles of surgery, radiotherapy, and chemotherapy in the management of patients with squamous cell carcinomas of the external auditory canal and middle ear. Methods and Materials: The records of 87 patients with histologically confirmed squamous cell carcinoma who were treated between 1984 and 2005 were reviewed. Fifty-three patients (61%) were treated with surgery and radiotherapy (S + RT group) and the remaining 34 patients with radiotherapy alone (RT group). Chemotherapy was administered in 34 patients (39%). Results: The 5-year actuarial overall and disease-free survival (DFS) rates for all patients were 55% and 54%, respectively. On univariate analysis, T stage (Stell's classification), treatment modality, and Karnofsky performance status had significant impact on DFS. On multivariate analysis, T stage and treatment modality were significant prognostic factors. Chemotherapy did not influence DFS. The 5-year DFS rate in T1, T2, and T3 patients was 83%, 45%, and 0 in the RT group (p < 0.0001) and 75%, 75%, and 46% in the S + RT group (p = 0.13), respectively. The 5-year DFS rate in patients with negative surgical margins, those with positive margins, and those with macroscopic residual disease was 83%, 55%, and 38%, respectively (p = 0.007). Conclusions: Radical radiotherapy is the treatment of choice for early-stage (T1) diseases, whereas surgery (negative surgical margins if possible) with radiotherapy is recommended as the standard care for advanced (T2-3) disease. Further clarification on the role of chemotherapy is necessary.

  6. An analysis of the acoustic input impedance of the ear.

    PubMed

    Withnell, Robert H; Gowdy, Lauren E

    2013-10-01

    Ear canal acoustics was examined using a one-dimensional lossy transmission line with a distributed load impedance to model the ear. The acoustic input impedance of the ear was derived from sound pressure measurements in the ear canal of healthy human ears. A nonlinear least squares fit of the model to data generated estimates for ear canal radius, ear canal length, and quantified the resistance that would produce transmission losses. Derivation of ear canal radius has application to quantifying the impedance mismatch at the eardrum between the ear canal and the middle ear. The length of the ear canal was found, in general, to be longer than the length derived from the one-quarter wavelength standing wave frequency, consistent with the middle ear being mass-controlled at the standing wave frequency. Viscothermal losses in the ear canal, in some cases, may exceed that attributable to a smooth rigid wall. Resistance in the middle ear was found to contribute significantly to the total resistance. In effect, this analysis "reverse engineers" physical parameters of the ear from sound pressure measurements in the ear canal.

  7. Innovative Hands-on Activities for Middle School Science.

    ERIC Educational Resources Information Center

    Barry, Dana M.

    This paper contains some hands-on activities that relate science to art and language arts. The focus is placed on middle schools and activities engage students in the discovery that chemicals are used to draw and color. Students also read and write poetry and literature that employ science-related topics. A number of spin-off activities are…

  8. Ear emergencies

    MedlinePlus

    ... and ruptured eardrums can be caused by: Inserting cotton swabs, toothpicks, pins, pens, or other objects into ... The person will have severe pain. Place sterile cotton gently in the outer ear canal to keep ...

  9. Elephant ear

    MedlinePlus

    The harmful substances in elephant ear plants are: Oxalic acid Asparagine, a protein found in this plant Note: ... days to a week if treated correctly. Rarely, oxalic acid may cause swelling severe enough to block the ...

  10. The Role of EGFR/PI3K/Akt/cyclinD1 Signaling Pathway in Acquired Middle Ear Cholesteatoma

    PubMed Central

    Liu, Wei; Ren, Hongmiao; Ren, Jihao; Yin, Tuanfang; Hu, Bing; Xie, Shumin; Dai, Yinghuan; Wu, Weijing; Xiao, Zian; Yang, Xinming; Xie, Dinghua

    2013-01-01

    Cholesteatoma is a benign keratinizing and hyper proliferative squamous epithelial lesion of the temporal bone. Epidermal growth factor (EGF) is one of the most important cytokines which has been shown to play a critical role in cholesteatoma. In this investigation, we studied the effects of EGF on the proliferation of keratinocytes and EGF-mediated signaling pathways underlying the pathogenesis of cholesteatoma. We examined the expressions of phosphorylated EGF receptor (p-EGFR), phosphorylated Akt (p-Akt), cyclinD1, and proliferating cell nuclear antigen (PCNA) in 40 cholesteatoma samples and 20 samples of normal external auditory canal (EAC) epithelium by immunohistochemical method. Furthermore, in vitro studies were performed to investigate EGF-induced downstream signaling pathways in primary external auditory canal keratinocytes (EACKs). The expressions of p-EGFR, p-Akt, cyclinD1, and PCNA in cholesteatoma epithelium were significantly increased when compared with those of control subjects. We also demonstrated that EGF led to the activation of the EGFR/PI3K/Akt/cyclinD1 signaling pathway, which played a critical role in EGF-induced cell proliferation and cell cycle progression of EACKs. Both EGFR inhibitor AG1478 and PI3K inhibitor wortmannin inhibited the EGF-induced EGFR/PI3K/Akt/cyclinD1 signaling pathway concomitantly with inhibition of cell proliferation and cell cycle progression of EACKs. Taken together, our data suggest that the EGFR/PI3K/Akt/cyclinD1 signaling pathway is active in cholesteatoma and may play a crucial role in cholesteatoma epithelial hyper-proliferation. This study will facilitate the development of potential therapeutic targets for intratympanic drug therapy for cholesteatoma. PMID:24311896

  11. Third place--Resident Basic Science Award 1990. Interleukin 1 causing bone destruction in middle ear cholesteatoma.

    PubMed

    Ahn, J M; Huang, C C; Abramson, M

    1990-10-01

    We previously reported the localization of interleukin 1 in the epithelial layer of human cholesteatomas. On the basis of other studies that showed interleukin 1 can stimulate fibroblasts and macrophages to produce collagenases and prostaglandins, we then proposed that interleukin 1 may play an important role in cholesteatoma-related bone resorption, also. Our immunocytochemical study involving more human cholesteatoma samples revealed the presence of interleukin 1 in bone cells and monocytes in the region of active bone destruction. In the present study, the effect of interleukin 1 on these cells found at the bone resorption site was examined. By radioimmunoassay, interleukin 1 was shown to stimulate the production of prostaglandin E2 by osteoblasts in vitro. Interleukin 1 also promoted the migration and multinucleation of bone marrow-derived monocytes. These osteoclast-like cells formed from monocytes contained tartrate-resistant acid phosphatase, and caused the resorption of the devitalized bone in vitro. Above findings suggest that interleukin 1 could cause the bone destruction in cholesteatomas, not only by stimulating the local bone cells, but also by recruiting monocytes for osteoclastic bone resorption.

  12. The Relationship between Active Hand and Ear Advantage in the Native and Foreign Language

    ERIC Educational Resources Information Center

    Mildner, V.; Stankovic, D.; Petkovic, M.

    2005-01-01

    In an experimental design involving two auditorily presented competing commands (one to each ear), 144 right-handed subjects (72 male and 72 female) were asked to provide motor responses. Half of each group of subjects was responding with their right hand and the other half with the left. The test was applied in the subjects' native language…

  13. Developing Science and Math Integrated Activities for Middle School Students

    ERIC Educational Resources Information Center

    Sherrod, Sonya Ellouise; Dwyer, Jerry; Narayan, Ratna

    2009-01-01

    This article reports the development and refinement of science and mathematics integrated activities for middle school students. The expectations of the National Council of Teachers of Mathematics that students develop an understanding of mathematics and an ability to apply it gave birth to these activities. The expectations of the National…

  14. Introduction to Vocations Comprehensive Middle School Program: Mathematics Activities.

    ERIC Educational Resources Information Center

    Gartner, Karen; And Others

    Junior high or middle school student activities in mathematics are provided for three entry level occupations in each of fifteen career clusters. The fifteen cluster titles including one of the three occupations for each cluster with an example of a student activity follow: (1) Agri-business and Natural Resources (cropdusting pilot, reading an…

  15. Peer Listening in the Middle School: Training Activities for Students.

    ERIC Educational Resources Information Center

    Hazouri, Sandra Peyser; Smith, Miriam Frey

    This workbook presents activities for training middle school student peer listeners. The first of the workbook's 10 chapters contains an introduction to peer listening. Activities include a pretest on a series of true-false statements called the "Peer Listening Inventory," defining the meaning of the words that describe the qualities of a peer…

  16. Active Learning in the Middle Grades

    ERIC Educational Resources Information Center

    Edwards, Susan

    2015-01-01

    What is active learning and what does it look like in the classroom? If students are participating in active learning, they are playing a more engaged role in the learning process and are not overly reliant on the teacher (Bransford, Brown, & Cocking, 2003; Petress, 2008). The purpose of this article is to propose a framework to describe and…

  17. High detection rates of nucleic acids of a wide range of respiratory viruses in the nasopharynx and the middle ear of children with a history of recurrent acute otitis media.

    PubMed

    Wiertsema, Selma P; Chidlow, Glenys R; Kirkham, Lea-Ann S; Corscadden, Karli J; Mowe, Eva N; Vijayasekaran, Shyan; Coates, Harvey L; Harnett, Gerald B; Richmond, Peter C

    2011-11-01

    Both bacteria and viruses play a role in the development of acute otitis media, however, the importance of specific viruses is unclear. In this study molecular methods were used to determine the presence of nucleic acids of human rhinoviruses (HRV; types A, B, and C), respiratory syncytial viruses (RSV; types A and B), bocavirus (HBoV), adenovirus, enterovirus, coronaviruses (229E, HKU1, NL63, and OC43), influenza viruses (types A, B, and C), parainfluenza viruses (types 1, 2, 3, 4A, and 4B), human metapneumovirus, and polyomaviruses (KI and WU) in the nasopharynx of children between 6 and 36 months of age either with (n = 180) or without (n = 66) a history of recurrent acute otitis media and in 238 middle ear effusion samples collected from 143 children with recurrent acute otitis media. The co-detection of these viruses with Streptococcus pneumoniae, nontypeable Haemophilus influenzae, and Moraxella catarrhalis was analyzed. HRV (58.3% vs. 42.4%), HBoV (52.2% vs. 19.7%), polyomaviruses (36.1% vs. 15.2%), parainfluenza viruses (29.4% vs. 9.1%), adenovirus (25.0% vs. 6.1%), and RSV (27.8% vs. 9.1%) were detected significantly more often in the nasopharynx of children with a history of recurrent acute otitis media compared to healthy children. HRV was predominant in the middle ear and detected in middle ear effusion of 46% of children. Since respiratory viruses were detected frequently in the nasopharynx of both children with and without a history of recurrent acute otitis media, the etiological role of specific viruses in recurrent acute otitis media remains uncertain, however, anti-viral therapies may be beneficial in future treatment and prevention strategies for acute otitis media.

  18. Development and Integration of the Ear.

    PubMed

    Fuchs, Jennifer C; Tucker, Abigail S

    2015-01-01

    The perception of our environment via sensory organs plays a crucial role in survival and evolution. Hearing, one of our most developed senses, depends on the proper function of the auditory system and plays a key role in social communication, integration, and learning ability. The ear is a composite structure, comprised of the external, middle, and inner ear. During development, the ear is formed from the integration of a number of tissues of different embryonic origin, which initiate in distinct areas of the embryo at different time points. Functional connections between the components of the hearing apparatus have to be established and maintained during development and adulthood to allow proper sound submission from the outer to the middle and inner ear. This highly organized and intimate connectivity depends on intricate spatiotemporal signaling between the various tissues that give rise to the structures of the ear. Any alterations in this chain of events can lead to the loss of integration, which can subsequently lead to conductive hearing loss, in case of outer and middle ear defects or sensorineural hearing loss, if inner ear structures are defective. This chapter aims to review the current knowledge concerning the development of the three ear compartments as well as mechanisms and signaling pathways that have been implicated in the coordination and integration process of the ear.

  19. Development and Integration of the Ear.

    PubMed

    Fuchs, Jennifer C; Tucker, Abigail S

    2015-01-01

    The perception of our environment via sensory organs plays a crucial role in survival and evolution. Hearing, one of our most developed senses, depends on the proper function of the auditory system and plays a key role in social communication, integration, and learning ability. The ear is a composite structure, comprised of the external, middle, and inner ear. During development, the ear is formed from the integration of a number of tissues of different embryonic origin, which initiate in distinct areas of the embryo at different time points. Functional connections between the components of the hearing apparatus have to be established and maintained during development and adulthood to allow proper sound submission from the outer to the middle and inner ear. This highly organized and intimate connectivity depends on intricate spatiotemporal signaling between the various tissues that give rise to the structures of the ear. Any alterations in this chain of events can lead to the loss of integration, which can subsequently lead to conductive hearing loss, in case of outer and middle ear defects or sensorineural hearing loss, if inner ear structures are defective. This chapter aims to review the current knowledge concerning the development of the three ear compartments as well as mechanisms and signaling pathways that have been implicated in the coordination and integration process of the ear. PMID:26589927

  20. Ear examination

    MedlinePlus

    The ear canal differs in size, shape, and color from person to person. Normally, the canal is skin-colored and has small hairs. Yellowish-brown earwax may be present. The eardrum is a light-gray color or a shiny pearly-white. Light should reflect off ...

  1. Cosmetic ear surgery

    MedlinePlus

    Otoplasty; Ear pinning; Ear surgery - cosmetic; Ear reshaping; Pinnaplasty ... Cosmetic ear surgery may be done in the surgeon's office, an outpatient clinic, or a hospital. It can be performed under ...

  2. Ear Plastic Surgery

    MedlinePlus

    ... Meeting Calendar Find an ENT Doctor Near You Ear Plastic Surgery Ear Plastic Surgery Patient Health Information ... they may improve appearance and self-confidence. Can Ear Deformities Be Corrected? Formation of the ear during ...

  3. Autoimmune Inner Ear Disease

    MedlinePlus

    ... Find an ENT Doctor Near You Autoimmune Inner Ear Disease Autoimmune Inner Ear Disease Patient Health Information ... with a hearing loss. How Does the Healthy Ear Work? The ear has three main parts: the ...

  4. Better Ear Health

    MedlinePlus

    ... Calendar Find an ENT Doctor Near You Better Ear Health Better Ear Health Patient Health Information News ... often helpful to those with this condition. Swimmer’s Ear An infection of the outer ear structures caused ...

  5. How the Ear Works

    MedlinePlus

    ... Find an ENT Doctor Near You How the Ear Works How the Ear Works Patient Health Information News media interested in ... public relations staff at newsroom@entnet.org . The ear has three main parts: the outer ear (including ...

  6. Technical note: Evaluation of an ear-attached movement sensor to record cow feeding behavior and activity.

    PubMed

    Bikker, J P; van Laar, H; Rump, P; Doorenbos, J; van Meurs, K; Griffioen, G M; Dijkstra, J

    2014-05-01

    The ability to monitor dairy cow feeding behavior and activity could improve dairy herd management. A 3-dimensional accelerometer (SensOor; Agis Automatisering BV, Harmelen, the Netherlands) has been developed that can be attached to ear identification tags. Based on the principle that behavior can be identified by ear movements, a proprietary model classifies sensor data as "ruminating," "eating," "resting," or "active." The objective of the study was to evaluate this sensor on accuracy and precision. First, a pilot evaluation of agreement between 2 independent observers, recording behavior from 3 cows for a period of approximately 9h each, was performed. Second, to evaluate the sensor, the behavior of 15 cows was monitored both visually (VIS) and with the sensor (SENS), with approximately 20 h of registration per cow, evenly distributed over a 24-h period, excluding milking. Cows were chosen from groups of animals in different lactation stages and parities. Each minute of SENS and VIS data was classified into 1 of 9 categories (8 behaviors and 1 transition behavior) and summarized into 4 behavioral groups, namely ruminating, eating, resting, or active, which were analyzed by calculating kappa (κ) values. For the pilot evaluation, a high level of agreement between observers was obtained, with κ values of ≥ 0.96 for all behavioral categories, indicating that visual observation provides a good standard. For the second trial, relationships between SENS and VIS were studied by κ values on a minute basis and Pearson correlation and concordance correlation coefficient analysis on behavior expressed as percentage of total registration time. Times spent ruminating, eating, resting, and active were 42.6, 15.9, 31.6, and 9.9% (SENS) respectively, and 42.1, 13.0, 30.0, and 14.9% (VIS), respectively. Overall κ for the comparison of SENS and VIS was substantial (0.78), with κ values of 0.85, 0.77, 0.86, and 0.47 for "ruminating," "eating," "resting," and "active

  7. [Inner Ear Hearing Loss].

    PubMed

    Hesse, G

    2016-06-01

    Hearing loss is one of the most dominant handicaps in modern societies, which additionally very often is not realized or not admitted. About one quarter of the general population suffers from inner ear hearing loss and is therefore restricted in communicational skills. Demographic factors like increasing age play an important role as well as environmental influences and an increasing sound and noise exposure especially in leisure activities. Thus borders between a "classical" presbyacusis - if it ever existed - and envirionmentally induced hearing loss disappear. Today restrictions in hearing ability develop earlier in age but at the same time they are detected and diagnosed earlier. This paper can eventually enlighten the wide field of inner ear hearing loss only fragmentarily; therefore mainly new research, findings and developments are reviewed. The first part discusses new aspects of diagnostics of inner ear hearing loss and different etiologies. PMID:27259171

  8. Role of phospholipase D and diacylglycerol in activating constitutive TRPC-like cation channels in rabbit ear artery myocytes.

    PubMed

    Albert, A P; Piper, A S; Large, W A

    2005-08-01

    Previously we have described a constitutively active Ca2+-permeable non-selective cation channel in freshly dispersed rabbit ear artery myocytes that has similar properties to canonical transient receptor potential (TRPC) channel proteins. In the present study we have investigated the transduction pathways responsible for stimulating constitutive channel activity in these myocytes. Application of the pharmacological inhibitors of phosphatidylcholine-phospholipase D (PC-PLD), butan-1-ol and C2 ceramide, produced marked inhibition of constitutive channel activity in cell-attached patches and also butan-1-ol produced pronounced suppression of resting membrane conductance measured with whole-cell recording whereas the inactive isomer butan-2-ol had no effect on constitutive whole-cell or channel activity. In addition butan-1-ol had no effect on channel activity evoked by the diacylglycerol (DAG) analogue 1-oleoyl-2-acetyl-sn-glycerol (OAG). Inhibitors of PC-phospholipase C (PC-PLC) and phospholipase A2 (PLA2) had no effect on constitutive channel activity. Application of a purified PC-PLD enzyme and its metabolite phosphatidic acid to inside-out patches markedly increased channel activity. The phosphatidic acid phosphohydrolase (PAP) inhibitor dl-propranolol also inhibited constitutive and phosphatidic acid-induced increases in channel activity but had no effect on OAG-evoked responses. The DAG lipase and DAG kinase inhibitors, RHC80267 and R59949 respectively, which inhibit DAG metabolism, produced transient increases in channel activity which were mimicked by relatively high concentrations (40 microm) of OAG. The protein kinase C (PKC) inhibitor chelerythrine did not prevent channel activation by OAG but blocked the secondary inhibitory response of OAG. It is proposed that endogenous DAG is involved in the activation of channel activity and that its effects on channel activity are concentration-dependent with higher concentrations of DAG also inhibiting channel

  9. Role of phospholipase D and diacylglycerol in activating constitutive TRPC-like cation channels in rabbit ear artery myocytes.

    PubMed

    Albert, A P; Piper, A S; Large, W A

    2005-08-01

    Previously we have described a constitutively active Ca2+-permeable non-selective cation channel in freshly dispersed rabbit ear artery myocytes that has similar properties to canonical transient receptor potential (TRPC) channel proteins. In the present study we have investigated the transduction pathways responsible for stimulating constitutive channel activity in these myocytes. Application of the pharmacological inhibitors of phosphatidylcholine-phospholipase D (PC-PLD), butan-1-ol and C2 ceramide, produced marked inhibition of constitutive channel activity in cell-attached patches and also butan-1-ol produced pronounced suppression of resting membrane conductance measured with whole-cell recording whereas the inactive isomer butan-2-ol had no effect on constitutive whole-cell or channel activity. In addition butan-1-ol had no effect on channel activity evoked by the diacylglycerol (DAG) analogue 1-oleoyl-2-acetyl-sn-glycerol (OAG). Inhibitors of PC-phospholipase C (PC-PLC) and phospholipase A2 (PLA2) had no effect on constitutive channel activity. Application of a purified PC-PLD enzyme and its metabolite phosphatidic acid to inside-out patches markedly increased channel activity. The phosphatidic acid phosphohydrolase (PAP) inhibitor dl-propranolol also inhibited constitutive and phosphatidic acid-induced increases in channel activity but had no effect on OAG-evoked responses. The DAG lipase and DAG kinase inhibitors, RHC80267 and R59949 respectively, which inhibit DAG metabolism, produced transient increases in channel activity which were mimicked by relatively high concentrations (40 microm) of OAG. The protein kinase C (PKC) inhibitor chelerythrine did not prevent channel activation by OAG but blocked the secondary inhibitory response of OAG. It is proposed that endogenous DAG is involved in the activation of channel activity and that its effects on channel activity are concentration-dependent with higher concentrations of DAG also inhibiting channel

  10. Failure of dominant left-hemispheric activation to right-ear stimulation in schizophrenia.

    PubMed

    Rockstroh, B; Clementz, B A; Pantev, C; Blumenfeld, L D; Sterr, A; Elbert, T

    1998-12-01

    Schizophrenia is associated with an absence of the lateralizations that typify the human brain. Previous evidence emphasized structural changes, particularly reduced asymmetry in extension and surface of the planum temporale, although gross structural deviations occur only in a minority of patients. The present study describes an absence of lateralization on a robust functional measure that characterized schizophrenia patients: healthy subjects but not schizophrenics displayed a contralateral left-hemispheric dominance of the auditory evoked magnetic field to right-ear auditory stimulation. Absence of contralateral dominance in response to auditory stimuli among schizophrenia patients may indicate a failure to establish unequivocal left-hemispheric dominance of the phonological loop as hypothesized by Crow. PMID:9875711

  11. RAF Kinase Activity Regulates Neuroepithelial Cell Proliferation and Neuronal Progenitor Cell Differentiation during Early Inner Ear Development

    PubMed Central

    Magariños, Marta; Aburto, María R.; Sánchez-Calderón, Hortensia; Muñoz-Agudo, Carmen; Rapp, Ulf R.; Varela-Nieto, Isabel

    2010-01-01

    Background Early inner ear development requires the strict regulation of cell proliferation, survival, migration and differentiation, coordinated by the concerted action of extrinsic and intrinsic factors. Deregulation of these processes is associated with embryonic malformations and deafness. We have shown that insulin-like growth factor I (IGF-I) plays a key role in embryonic and postnatal otic development by triggering the activation of intracellular lipid and protein kinases. RAF kinases are serine/threonine kinases that regulate the highly conserved RAS-RAF-MEK-ERK signaling cascade involved in transducing the signals from extracellular growth factors to the nucleus. However, the regulation of RAF kinase activity by growth factors during development is complex and still not fully understood. Methodology/Principal Findings By using a combination of qRT-PCR, Western blotting, immunohistochemistry and in situ hybridization, we show that C-RAF and B-RAF are expressed during the early development of the chicken inner ear in specific spatiotemporal patterns. Moreover, later in development B-RAF expression is associated to hair cells in the sensory patches. Experiments in ex vivo cultures of otic vesicle explants demonstrate that the influence of IGF-I on proliferation but not survival depends on RAF kinase activating the MEK-ERK phosphorylation cascade. With the specific RAF inhibitor Sorafenib, we show that blocking RAF activity in organotypic cultures increases apoptosis and diminishes the rate of cell proliferation in the otic epithelia, as well as severely impairing neurogenesis of the acoustic-vestibular ganglion (AVG) and neuron maturation. Conclusions/Significance We conclude that RAF kinase activity is essential to establish the balance between cell proliferation and death in neuroepithelial otic precursors, and for otic neuron differentiation and axonal growth at the AVG. PMID:21203386

  12. Benign ear cyst or tumor

    MedlinePlus

    Osteomas; Exostoses; Tumor - ear; Cysts - ear; Ear cysts; Ear tumors; Bony tumor of the ear canal ... bony tumors of the ear canal (exostoses and osteomas) are caused by excess growth of bone. Repeated ...

  13. Earthquake Model of the Middle East (EMME) Project: Active Fault Database for the Middle East Region

    NASA Astrophysics Data System (ADS)

    Gülen, L.; Wp2 Team

    2010-12-01

    The Earthquake Model of the Middle East (EMME) Project is a regional project of the umbrella GEM (Global Earthquake Model) project (http://www.emme-gem.org/). EMME project region includes Turkey, Georgia, Armenia, Azerbaijan, Syria, Lebanon, Jordan, Iran, Pakistan, and Afghanistan. Both EMME and SHARE projects overlap and Turkey becomes a bridge connecting the two projects. The Middle East region is tectonically and seismically very active part of the Alpine-Himalayan orogenic belt. Many major earthquakes have occurred in this region over the years causing casualties in the millions. The EMME project will use PSHA approach and the existing source models will be revised or modified by the incorporation of newly acquired data. More importantly the most distinguishing aspect of the EMME project from the previous ones will be its dynamic character. This very important characteristic is accomplished by the design of a flexible and scalable database that will permit continuous update, refinement, and analysis. A digital active fault map of the Middle East region is under construction in ArcGIS format. We are developing a database of fault parameters for active faults that are capable of generating earthquakes above a threshold magnitude of Mw≥5.5. Similar to the WGCEP-2007 and UCERF-2 projects, the EMME project database includes information on the geometry and rates of movement of faults in a “Fault Section Database”. The “Fault Section” concept has a physical significance, in that if one or more fault parameters change, a new fault section is defined along a fault zone. So far over 3,000 Fault Sections have been defined and parameterized for the Middle East region. A separate “Paleo-Sites Database” includes information on the timing and amounts of fault displacement for major fault zones. A digital reference library that includes the pdf files of the relevant papers, reports is also being prepared. Another task of the WP-2 of the EMME project is to prepare

  14. Non-explosive blast injury of the ear.

    PubMed

    Berger, G; Finkelstein, Y; Harell, M

    1994-05-01

    Non-explosive blast injury of the ear refers to the otological trauma caused by a blow to the ear that seals the external auditory meatus. It results in a sudden increase of air pressure within the ear canal that strikes the tympanic membrane. The present study portrays the various aspects of middle and inner ear damage in 91 patients resulting from an assault we entitled a 'non-explosive blast injury' to the ear. Sixty cases were caused by a slap or a fist, 13 patients suffered sport accidents, mostly in ball games, and 18 patients were injured during swimming and water sports activities. The common symptoms were hearing loss, earache, tinnitus, vertigo and otorrhoea. All 91 patients presented with acute perforations of their eardrums. The mean conductive hearing loss was 11.2 dB. A high tone sensorineural hearing loss was detected in only 20 per cent of the patients. A spontaneous closure of the perforation with a conservative management approach was observed in 94.8 per cent of the patients. Healing of the perforation was always associated with closure of the air-bone gap, while the results of the sensorineural hearing loss recovery were less favourable.

  15. A comprehensive model of human ear for analysis of implantable hearing devices.

    PubMed

    Zhang, Xiangming; Gan, Rong Z

    2011-10-01

    A finite element (FE) model of the human ear including the ear canal, middle ear, and spiral cochlea was constructed from histological sections of human temporal bone. Multiphysics analysis of the acoustics, structure, and fluid coupling in the ear was conducted in the model. The viscoelastic material behavior was applied to the middle ear soft tissues based on dynamic measurements of tissues in our laboratory. The FE model was first validated using the experimental data obtained in human cadaver ears, and then used to investigate the efficiency of the forward and reverse mechanical driving with middle ear implant, and the passive vibration of basilar membrane (BM) with cochlear implant placed in the cochlear scala tympani. The middle ear transfer function and the cochlear function of the BM vibration were derived from the model. This comprehensive ear model provides a novel computational tool to visualize and compute the implantable hearing devices and surgical procedures.

  16. A comprehensive model of human ear for analysis of implantable hearing devices.

    PubMed

    Zhang, Xiangming; Gan, Rong Z

    2011-10-01

    A finite element (FE) model of the human ear including the ear canal, middle ear, and spiral cochlea was constructed from histological sections of human temporal bone. Multiphysics analysis of the acoustics, structure, and fluid coupling in the ear was conducted in the model. The viscoelastic material behavior was applied to the middle ear soft tissues based on dynamic measurements of tissues in our laboratory. The FE model was first validated using the experimental data obtained in human cadaver ears, and then used to investigate the efficiency of the forward and reverse mechanical driving with middle ear implant, and the passive vibration of basilar membrane (BM) with cochlear implant placed in the cochlear scala tympani. The middle ear transfer function and the cochlear function of the BM vibration were derived from the model. This comprehensive ear model provides a novel computational tool to visualize and compute the implantable hearing devices and surgical procedures. PMID:21708496

  17. Ear canal dynamic motion as a source of power for in-ear devices

    NASA Astrophysics Data System (ADS)

    Delnavaz, Aidin; Voix, Jérémie

    2013-02-01

    Ear canal deformation caused by temporomandibular joint (jaw joint) activity, also known as "ear canal dynamic motion," is introduced in this paper as a candidate source of power to possibly recharge hearing aid batteries. The geometrical deformation of the ear canal is quantified in 3D by laser scanning of different custom ear moulds. An experimental setup is proposed to measure the amount of power potentially available from this source. The results show that 9 mW of power is available from a 15 mm3 dynamic change in the ear canal volume. Finally, the dynamic motion and power capability of the ear canal are investigated in a group of 12 subjects.

  18. Hyaluronic acid liposomal gel sustains delivery of a corticoid to the inner ear.

    PubMed

    El Kechai, Naila; Mamelle, Elisabeth; Nguyen, Yann; Huang, Nicolas; Nicolas, Valérie; Chaminade, Pierre; Yen-Nicolaÿ, Stéphanie; Gueutin, Claire; Granger, Benjamin; Ferrary, Evelyne; Agnely, Florence; Bochot, Amélie

    2016-03-28

    The inner ear is one of the most challenging organs for drug delivery, mainly because of the blood-perilymph barrier. Therefore, local rather than systemic drug delivery methods are being developed for inner ear therapy. In this work, we have evaluated the benefit of a hyaluronic acid liposomal gel for sustained delivery of a corticoid to the inner ear after local injection into the middle ear in a guinea pig model. The liposomal gel was easily injectable as a result of the shear-thinning behavior of hyaluronic acid. A prolonged residence time at the site of injection as well as in the round window were achieved without any negative effect on the hearing thresholds of the animals. The presence of liposomes in the formulation resulted in sustained release of the drug in the perilymph for 30days and promoted the conversion of the prodrug loaded within the liposomes (dexamethasone phosphate) into its active form (dexamethasone). In this way, therapeutic doses were attained in the perilymph. A small amount of intact liposomes was visualized in the perilymph, whereas the main proportion of liposomes seemed to be trapped in the round window resulting in a reservoir effect. Thus, the administration of hyaluronic acid liposomal gel to the middle ear is an efficient strategy for delivering corticoids to the inner ear in a sustained manner.

  19. Ears and Altitude

    MedlinePlus

    ... Meeting Calendar Find an ENT Doctor Near You Ears and Altitude Ears and Altitude Patient Health Information ... uncomfortable feeling of fullness or pressure. Why do ears pop? Normally, swallowing causes a little click or ...

  20. Travel Inside the Ear

    MedlinePlus

    ... Menu Home Health Info Hearing, Ear Infections, and Deafness Balance Taste and Smell Voice, Speech, and Language ... here Home » Health Info » Hearing, Ear Infections, and Deafness Travel Inside the Ear Video When sound waves ...

  1. Sudden Cardiac Arrest During Sports Activity in Middle Age

    PubMed Central

    Marijon, Eloi; Uy-Evanado, Audrey; Reinier, Kyndaron; Teodorescu, Carmen; Narayanan, Kumar; Jouven, Xavier; Gunson, Karen; Jui, Jonathan; Chugh, Sumeet S.

    2015-01-01

    Background Sports-associated sudden cardiac arrests (SCAs) occur mostly during middle age. We sought to determine burden, characteristics, and outcomes of SCA during sports among middle aged residents of a large US community. Methods and Results SCA cases aged 35–65 years were identified in a large, prospective, population-based study (2002–2013), with systematic and comprehensive assessment of their lifetime medical history. Of the 1,247 SCA cases, 63 (5%) occurred during sports activities at a mean age of 51.1±8.8 years, yielding an incidence of 21.7 (95%CI 8.1–35.4) per million per year. The incidence varied significantly based on sex, with a higher incidence among men (RR 18.68 95%CI 2.50–139.56) for sports SCA, as compared to all other SCA (RR 2.58, 95%CI 2.12–3.13). Sports SCA was also more likely to be a witnessed event (87 vs. 53%, P<0.001), with cardiopulmonary resuscitation (44 vs. 25%, P=0.001) and ventricular fibrillation (84 vs. 51%, P<0.0001). Survival to hospital discharge was higher for sports-associated SCA (23.2 vs. 13.6%, P=0.04). Sports SCA cases presented with known pre-existing cardiac disease in 16%, ≥1 cardiovascular risk factor in 56%, and overall, 36% of cases had typical cardiovascular symptoms during the week preceding SCA. Conclusions Sports-associated SCA in middle age represents a relatively small proportion of the overall SCA burden, reinforcing the idea of the high benefit-low risk nature of sports activity. Especially in light of current population aging trends, our findings emphasize that targeted education could maximize both safety and acceptance of sports activity in the older athlete. PMID:25847988

  2. Physical mechanisms of solar activity effects in the middle atmosphere

    NASA Technical Reports Server (NTRS)

    Ebel, A.

    1989-01-01

    A great variety of physical mechanisms of possibly solar induced variations in the middle atmosphere has been discussed in the literature during the last decades. The views which have been put forward are often controversial in their physical consequences. The reason may be the complexity and non-linearity of the atmospheric response to comparatively weak forcing resulting from solar activity. Therefore this review focuses on aspects which seem to indicate nonlinear processes in the development of solar induced variations. Results from observations and numerical simulations are discussed.

  3. An evaluation of tympanometric estimates of ear canal volume.

    PubMed

    Shanks, J E; Lilly, D J

    1981-12-01

    The accuracy of tympanometric estimates of ear canal volume was evaluated by testing the following two assumptions on which the procedure is based: (a) ear canal volume does not change when ear canal pressure is varied, and (b) an ear canal pressure of 200 daPa drives the impedance of the middle ear transmission system to infinity so the immittance measured at 200 daPa can be attributed to the ear canal volume alone. The first assumption was tested by measuring the changes in ear canal volume in eight normal subjects for ear canal pressures between +/- 400 daPa using a manometric procedure based on Boyle's gas law. The data did not support the first assumption. Ear canal volume changed by a mean of .113 ml over the +/- 400 daPa pressure range with slightly larger volume changes occurring for negative ear canal pressures than for positive ear canal pressures. Most of the volume change was attributed to movement of the probe and to movement of the cartilaginous walls of the ear canal. The second assumption was tested by comparing estimates of ear canal volume from susceptance tympanograms with a direct measurement of ear canal volume adjusted for changes in volume due to changes in ear canal pressure between +/- 400 daPa. These data failed to support the second assumption. All tympanometric estimates of ear canal volume were larger than the measured volumes. The largest error (39%) occurred for an ear canal pressure of 200 daPa at 220 Hz, whereas the smallest error (10%) occurred for an ear canal pressure of -400 daPa at 660 Hz. This latter susceptance value (-400 daPa at 660 Hz) divided by three is suggested to correct the 220-Hz tympanogram to the plane of the tympanic membrane. Finally, the effects of errors in estimating ear canal volume on static immittance and on tympanometry are discussed. PMID:7329051

  4. Ear disorders in scuba divers.

    PubMed

    Azizi, M H

    2011-01-01

    History of underwater diving dates back to antiquity. Breath-hold technique in diving was known to the ancient nations. However, deep diving progressed only in the early decades of the 19th century as the result of advancements in efficient underwater technologies which subsequently led to invention of sophisticated sets of scuba diving in the 20th century. Currently, diving is performed for various purposes including commercial, recreational, military, underwater construction, oil industry, underwater archeology and scientific assessment of marine life. By increasing popularity of underwater diving, dive-related medical conditions gradually became more evident and created a new challenge for the health care professionals, so that eventually, a specialty the so-called "diving medicine" was established. Most of the diving-associated disorders appear in the head and neck. The most common of all occupational disorders associated with diving are otologic diseases. External otitis has been reported as the most common otolaryngologic problem in underwater divers. Exostosis of the external ear canal may be formed in divers as the result of prolonged diving in cold waters. Other disorders of the ear and paranasal sinuses in underwater divers are caused by barometric pressure change (i.e., barotraumas), and to a lesser extent by decompression sickness. Barotrauma of the middle ear is the most prevalent barotrauma in divers. The inner ear barotraumas, though important, is less common. The present paper is a brief overview of diving-related ear disorders particularly in scuba divers.

  5. Dietary and Physical Activity Behaviors of Middle School Youth: The Youth Physical Activity and Nutrition Survey

    ERIC Educational Resources Information Center

    Zapata, Lauren B.; Bryant, Carol A.; McDermott, Robert J.; Hefelfinger, Jennie A.

    2008-01-01

    Background: Obesity has become a national epidemic among youth. Declining physical activity and poor nutrition contribute to this epidemic. The purpose of this study was to obtain data on middle school students' physical activity and nutrition knowledge and practices. Methods: The Youth Physical Activity and Nutrition Survey was developed and…

  6. Inner ear barotrauma from scuba diving.

    PubMed

    Sheridan, M F; Hetherington, H H; Hull, J J

    1999-03-01

    Inner ear barotrauma among scuba divers is believed to be caused by any of three conditions: a hemorrhage in the inner ear, a tear of the labyrinthine membrane, or a perilymphatic fistula. These injuries may occur concurrently or separately. Hemorrhage and membrane rupture are managed conservatively, while fistula requires surgical repair. In this report, we describe three cases of inner ear barotrauma in scuba divers. We also discuss the proposed etiologies of this injury and the controversy over whether or not divers who have suffered an inner ear trauma can safely resume scuba diving. Although the older literature clearly suggests otherwise, we believe that scuba divers who completely recover from inner (or middle) ear barotrauma may return to diving as long as they exercise caution and care.

  7. [The state of microcirculation in the middle ear structures at different stages of the treatment of the patients presenting with chronic otitis media].

    PubMed

    Belokopytova, E Iu; Fedoseev, V I; Pleshkov, V A

    2014-01-01

    The present work was designed to study dynamics of blood circulation in the tympanic membrane and tympanic cavity mucosa of 92 patients (105 ears) presenting with otosclerosis, adhesive non-perforative otitis media, and different stages of chronic suppurative otitis media. Normal characteristics of tympanic microcirculation were determined in 22 otologically healthy volunteers (30 ears). Laser Doppler flowmetry with the use of a specially designed probe (the outer diameter: 1.9 mm) was applied. The results of Doppler flowmetry varied in ontologically healthy subjects. The same circulation parameters in the vessels of the microcirculatory bed of the postero-superior quadrant of the tympanic membrane in the patients presenting with chronic suppurative otitis media at the stage of remission, otosclerosis, and adhesive non-perforative otitis media did not significantly differ from those of otologically healthy subjects. The blood flow was shown to increase in the tympanic membrane of the majority of the patients during the postoperative period (within 2nd to 4th weeks after types I-III tympanoplasty); thereafter, it either decreased or returned to the baseline level by weeks 6-8. Four months after the improvement of perfusion parameters of tympanic cavity mucosa and the arrest of exacerbation of mesotympanitis, characteristics of microcirculation in tympanic cavity mucosa were not significantly different from those of the patients with adhesive perforative otitis media. It is concluded that laser Doppler flowmetry may be used as an objective non-invasive technique for the study of microcirculation in the tympanic membrane and tympanic cavity mucosa.

  8. Chronic discharging ear in a child: are we missing something?

    PubMed

    Dutta, Mainak; Ghatak, Soumya; Biswas, Gautam

    2013-08-01

    Chronic discharging ear, mostly due to middle or external ear infection, is one of the leading causes for seeking healthcare among the paediatric population in a developing country. However, a long-standing forgotten middle ear foreign body forms a rare cause for such presentation demanding a high index of suspicion from the clinicians. Most of them are iatrogenic or accidental, and are removed by conventional permeatal approach; need for tympanotomy is rarely documented in the recent literature. We report the first case where a large stone was introduced into the middle ear through a pre-existing tympanic membrane perforation by the child himself, and only the second documentation of removal of a middle ear foreign body by tympanotomy in a child.

  9. Policies and Opportunities for Physical Activity in Middle School Environments

    PubMed Central

    Young, Deborah R.; Felton, Gwen M.; Grieser, Mira; Elder, John P.; Johnson, Carolyn; Lee, Jung-Sun; Kubik, Martha Y.

    2008-01-01

    BACKGROUND This study examined physical activity opportunities and barriers at 36 geographically diverse middle schools participating in the Trial of Activity for Adolescent Girls. METHODS Principals, physical education and health education department heads, and program leaders were interviewed to assess policies and instructional practices that support physical activity. RESULTS Schools provided approximately 110 hours per year in physical education instruction. Approximately 20% of students walked or bicycled to school. Eighty-three percent of schools offered interscholastic sports and 69% offered intramural sports. Most schools offered programs for girls, but on average, only 24 girls (~5%) in the schools attended any programs. Only 25% of schools allowed after school free play. An overall score created to assess school environmental support for physical activity indicated that, on average, schools met 6.7 items of 10 items. Free/reduced lunch program participation versus not (p = .04), perceived priority of physical education instruction over coaching (p = .02), and safety for walking/bicycling to school (p = .02) predicted environmental support score. CONCLUSIONS Schools have policies and practices that support physical activity, although unfavorable practices exist. Schools must work with community partners and officials to provide environments that optimally support physical activity, especially schools that serve low-income students. PMID:17212759

  10. Sedentary Activity and Body Composition of Middle School Girls: The Trial of Activity for Adolescent Girls

    ERIC Educational Resources Information Center

    Pratt, Charlotte; Webber, Larry S.; Baggett, Chris D.; Ward, Dianne; Pate, Russell R.; Murray, David; Lohman, Timothy; Lytle, Leslie; Elder, John P.

    2008-01-01

    This study describes the relationships between sedentary activity and body composition in 1,458 sixth-grade girls from 36 middle schools across the United States. Multivariate associations between sedentary activity and body composition were examined with regression analyses using general linear mixed models. Mean age, body mass index, and…

  11. Developmental and Individual Differences in Girls' Sex-Typed Activities in Middle Childhood and Adolescence

    ERIC Educational Resources Information Center

    McHale, Susan M.; Shanahan, Lilly; Updegraff, Kimberly A.; Crouter, Ann C.; Booth, Alan

    2004-01-01

    Girls' time in sex-typed leisure activities was studied across 2 years in middle childhood (n=98, M=8.2 years in Year 1), early adolescence (n=106, M=11.7 years), and middle adolescence (n=86, M=14.9 years). In annual home interviews, White middle-class girls, mothers, and fathers rated their gendered attitudes, interests, and personality…

  12. Coupling and Elastic Loading Affect the Active Response by the Inner Ear Hair Cell Bundles

    PubMed Central

    Strimbu, Clark Elliott; Fredrickson-Hemsing, Lea; Bozovic, Dolores

    2012-01-01

    Active hair bundle motility has been proposed to underlie the amplification mechanism in the auditory endorgans of non-mammals and in the vestibular systems of all vertebrates, and to constitute a crucial component of cochlear amplification in mammals. We used semi-intact in vitro preparations of the bullfrog sacculus to study the effects of elastic mechanical loading on both natively coupled and freely oscillating hair bundles. For the latter, we attached glass fibers of different stiffness to the stereocilia and observed the induced changes in the spontaneous bundle movement. When driven with sinusoidal deflections, hair bundles displayed phase-locked response indicative of an Arnold Tongue, with the frequency selectivity highest at low amplitudes and decreasing under stronger stimulation. A striking broadening of the mode-locked response was seen with increasing stiffness of the load, until approximate impedance matching, where the phase-locked response remained flat over the physiological range of frequencies. When the otolithic membrane was left intact atop the preparation, the natural loading of the bundles likewise decreased their frequency selectivity with respect to that observed in freely oscillating bundles. To probe for signatures of the active process under natural loading and coupling conditions, we applied transient mechanical stimuli to the otolithic membrane. Following the pulses, the underlying bundles displayed active movement in the opposite direction, analogous to the twitches observed in individual cells. Tracking features in the otolithic membrane indicated that it moved in phase with the bundles. Hence, synchronous active motility evoked in the system of coupled hair bundles by external input is sufficient to displace large overlying structures. PMID:22479461

  13. Coupling and elastic loading affect the active response by the inner ear hair cell bundles.

    PubMed

    Strimbu, Clark Elliott; Fredrickson-Hemsing, Lea; Bozovic, Dolores

    2012-01-01

    Active hair bundle motility has been proposed to underlie the amplification mechanism in the auditory endorgans of non-mammals and in the vestibular systems of all vertebrates, and to constitute a crucial component of cochlear amplification in mammals. We used semi-intact in vitro preparations of the bullfrog sacculus to study the effects of elastic mechanical loading on both natively coupled and freely oscillating hair bundles. For the latter, we attached glass fibers of different stiffness to the stereocilia and observed the induced changes in the spontaneous bundle movement. When driven with sinusoidal deflections, hair bundles displayed phase-locked response indicative of an Arnold Tongue, with the frequency selectivity highest at low amplitudes and decreasing under stronger stimulation. A striking broadening of the mode-locked response was seen with increasing stiffness of the load, until approximate impedance matching, where the phase-locked response remained flat over the physiological range of frequencies. When the otolithic membrane was left intact atop the preparation, the natural loading of the bundles likewise decreased their frequency selectivity with respect to that observed in freely oscillating bundles. To probe for signatures of the active process under natural loading and coupling conditions, we applied transient mechanical stimuli to the otolithic membrane. Following the pulses, the underlying bundles displayed active movement in the opposite direction, analogous to the twitches observed in individual cells. Tracking features in the otolithic membrane indicated that it moved in phase with the bundles. Hence, synchronous active motility evoked in the system of coupled hair bundles by external input is sufficient to displace large overlying structures. PMID:22479461

  14. Engineering design activities and conceptual change in middle school science

    NASA Astrophysics Data System (ADS)

    Schnittka, Christine G.

    persist when not specifically addressed. (2) Engineering design activities are not enough to promote conceptual change. (3) A middle school teacher can successfully implement an engineering design-based curriculum in a science class. (4) Results may also be of interest to science curriculum developers and engineering educators involved in developing engineering outreach curricula for middle school students.

  15. Recording and analysis of transient otoacoustic emissions during outer ear canal pressure compensation

    NASA Astrophysics Data System (ADS)

    Perez, Moises

    Otoacoustic Emissions (OAEs) are sounds generated by an active process in the auditory system's cochlea. It has been widely accepted that the generation of OAEs is a precursor for healthy hearing. The measurement of evoked OAEs can be used to determine the general health of the cochlea and basilar membrane's response and sound transmission forward and backwards through the inner ear. OAEs are commonly used for newborn infant hearing screening where many middle ear pathologies are first detected. In most cases, secondary screening tests such as tympanometry are not conducted unless the patient has failed the OAE screening first. Increases in ear canal pressure have an almost identical effect on OAE recordings when compared to naturally occurring negative middle ear pressures (NMEPs) (Sun & Shaver, 2009). Thus arises the need for pressure compensated OAE screening. This study aims at reviewing the design of a self-compensating pressure system capable of generating steady meatal pressures during OAE subject screening. Facets of system design including patient safety, software interaction, and initial test results will be presented. We will also present the results of a volunteer study which collected the TEOAE and meatal responses of 20 individual ears during multiple pressure criteria. Testing and analysis of signals in both the time and frequency domains will be reviewed.

  16. Plasma proteomic analysis of active and torpid greater mouse-eared bats (Myotis myotis)

    PubMed Central

    Hecht, Alexander M.; Braun, Beate C.; Krause, Eberhard; Voigt, Christian C.; Greenwood, Alex D.; Czirják, Gábor Á.

    2015-01-01

    Hibernation is a physiological adaptation to overcome extreme environmental conditions. It is characterized by prolonged periods of torpor interrupted by temporary arousals during winter. During torpor, body functions are suppressed and restored rapidly to almost pre-hibernation levels during arousal. Although molecular studies have been performed on hibernating rodents and bears, it is unclear how generalizable the results are among hibernating species with different physiology such as bats. As targeted blood proteomic analysis are lacking in small hibernators, we investigated the general plasma proteomic profile of European Myotis myotis and hibernation associated changes between torpid and active individuals by two-dimensional gel electrophoresis. Results revealed an alternation of proteins involved in transport, fuel switching, innate immunity and blood coagulation between the two physiological states. The results suggest that metabolic changes during hibernation are associated with plasma proteomic changes. Further characterization of the proteomic plasma profile identified transport proteins, coagulation proteins and complement factors and detected a high abundance of alpha-fetoprotein. We were able to establish for the first time a basic myotid bat plasma proteomic profile and further demonstrated a modulated protein expression during torpor in Myotis myotis, indicating both novel physiological pathways in bats in general, and during hibernation in particular. PMID:26586174

  17. Plasma proteomic analysis of active and torpid greater mouse-eared bats (Myotis myotis).

    PubMed

    Hecht, Alexander M; Braun, Beate C; Krause, Eberhard; Voigt, Christian C; Greenwood, Alex D; Czirják, Gábor Á

    2015-11-20

    Hibernation is a physiological adaptation to overcome extreme environmental conditions. It is characterized by prolonged periods of torpor interrupted by temporary arousals during winter. During torpor, body functions are suppressed and restored rapidly to almost pre-hibernation levels during arousal. Although molecular studies have been performed on hibernating rodents and bears, it is unclear how generalizable the results are among hibernating species with different physiology such as bats. As targeted blood proteomic analysis are lacking in small hibernators, we investigated the general plasma proteomic profile of European Myotis myotis and hibernation associated changes between torpid and active individuals by two-dimensional gel electrophoresis. Results revealed an alternation of proteins involved in transport, fuel switching, innate immunity and blood coagulation between the two physiological states. The results suggest that metabolic changes during hibernation are associated with plasma proteomic changes. Further characterization of the proteomic plasma profile identified transport proteins, coagulation proteins and complement factors and detected a high abundance of alpha-fetoprotein. We were able to establish for the first time a basic myotid bat plasma proteomic profile and further demonstrated a modulated protein expression during torpor in Myotis myotis, indicating both novel physiological pathways in bats in general, and during hibernation in particular.

  18. Conservative management of inner ear barotrauma resulting from scuba diving.

    PubMed

    Parell, G J; Becker, G D

    1985-06-01

    Fourteen patients who experienced inner ear barotrauma (IEBT) while scuba diving were examined shortly after the episode and were followed up until symptoms resolved or stabilized. On the basis of these observations and a review of the literature, three types of IEBT are hypothesized that usually result from forceful autoinflation of the middle ear: (1) hemorrhage within the inner ear, (2) labyrinthine membrane tear, and (3) perilymph fistula through the round or oval window. Presenting symptoms, treatment regimens, and final results are detailed.

  19. Injecting Computational Thinking into Computing Activities for Middle School Girls

    ERIC Educational Resources Information Center

    Webb, Heidi Cornelia

    2013-01-01

    Advances in technology have caused high schools to update their computer science curricula; however there has been little analogous attention to technology-related education in middle schools. With respect to computer-related knowledge and skills, middle school students are at a critical phase in life, exploring individualized education options…

  20. Ear drainage culture

    MedlinePlus

    ... needed. Your health care provider will use a cotton swab to collect the sample from inside the ... Using a cotton swab to take a sample of drainage from the outer ear is not painful. However, ear pain may ...